Fatigue Is a Major Symptom at COVID-19 Hospitalization Follow-Up

Abstract

Persistent symptoms after hospitalization with COVID-19 are common, but the frequency and severity of these symptoms are insufficiently understood. We aimed to describe symptoms and pulmonary function after hospitalization with COVID-19. Patients hospitalized with COVID-19 in Central Denmark Region were invited for follow-up 3 months after discharge. Clinical characteristics, patient reported outcomes (Fatigue Assessment Scale (FAS), anxiety and depression (HADS)), symptoms, pulmonary function test and 6-min walk test were collected. We included 218 patients (mean age 59.9 (95% CI: 58.2, 61.7), 59% males). Fatigue, dyspnea and impaired concentration were the most prevalent symptoms at follow-up. Using FAS, 47% reported mild-to-moderate fatigue and 18% severe fatigue. Mean HADS was 7.9 (95% CI: 6.9, 8.9). FAS was correlated to HADS (β = 0.52 (95% CI: 0.44, 0.59, p < 0.001)). Mean DLCO was 80.4% (95% CI: 77.8, 83.0) and 45% had DLCO ˂ 80%. Mean DLCO was significantly reduced in patients treated in the ICU (70.46% (95% CI 65.13, 75.79)). The highest FAS and HADS were seen in patients with the shortest period of hospitalization (2.1 days (95% CI: 1.4, 2.7)) with no need for oxygen. In conclusion, fatigue is a common symptom after hospitalization for COVID-19 and ICU treatment is associated to decreased diffusion capacity.

Prevalence of fatigue at one-year follow-up from the Gothenburg recovery and rehabilitation after COVID-19 and intensive care unit study

“…Post-COVID-19 is referred to as “the decrease in physical and/or mental performance that results from changes in central, psychological, and/or peripheral factors due to the COVID-19 disease” 5 . Previous literature shows that the prevalence of fatigue was 52% at 10 weeks 6 , 13–47% at 16–20 weeks 7 , 8 and 10–35% at 6 months 7 after COVID-19. The prevalence of post-COVID-19 fatigue was much higher in hospitalized individuals, with 36–53% reporting fatigue soon after the recovery from acute symptoms 9 , 10 , 26% at 3 months 11 , 63% at 6 months 12 and 20% at 1 year 13 after discharge from the hospital.…”

Twelve-month follow-up after hospitalization for SARS-COV-2: Physiology improves, symptoms remain

“…In a previous study, we examined symptoms using validated patient-reported outcome measures (PROMs) and objective outcomes, e.g., pulmonary function tests (PFT) and 6-minute walk test (6MWT) 3 months after hospitalization [10] . Fatigue measured by the Fatigue Assessment Scale (FAS) was a major complaint at follow-up, affecting 65% of patients of whom 18% reported severe fatigue [10] , in keeping with several other studies [11] , [12] , [13] .…”

Post‐COVID myopathy

“…Were antibodies against acetylcholine receptors or antibodies against musclespecific kinase positive in any of the included patients? Fatigue in post-COVID patients may be due not only to muscle involvement but also to cerebral involvement in the acute infection [5]. We should be told how many of the enrolled patients had clinical signs of central nervous system (CNS) involvement and how many showed cerebral magnetic resonance imaging CNS pathology that could explain fatigue.…”