Fatigue outcomes following coronavirus or influenza virus infection: A systematic review and meta-analysis

Abstract

ObjectivesFatigue is a pervasive clinical symptom for many infected with respiratory viruses such as influenza or coronaviruses. Prior evidence from influenza and coronavirus epidemics suggest that fatigue symptomology may continue beyond the acute phase, lasting for several months to several years post-discharge. This systematic review aimed to examine long-term fatigue prevalence among survivors and among communities, as well as investigate the current evidence for associated factors.DesignSystematic review and meta-analysis.SettingHospitalised and community samples.ParticipantsPatient populations with a confirmed diagnosis of a named influenza virus or coronavirus.Main outcomes measuredFatigue, fatigue syndromesResultsTen studies met the inclusion criteria for a pooled prevalence analysis and five studies were identified as eligible for a means differences analysis. A fatigue prevalence of 41% (95% CI 0.299-0.488) was found among a total population of 1,310. Using the ‘vitality’ subscale of the SF-36 as a proxy for fatigue, the estimate for means differences indicated a lower mean vitality score for survivors compared to population norms (M -1.523, CI -13.53 – 10.48), although this was not significant (p = 0.803). The most common associations with fatigue were PTSD, depression and anxiety, female gender and higher age.ConclusionsThis study reveals that a significant proportion of survivors (41%) experienced fatigue following their recovery from novel respiratory viruses such as SARS, MERS, SARS-CoV2 or influenza and that this fatigue can be long-lasting. Also, some factors such as female gender and psychological factors may contribute to continuing fatigue outcomes for this population.Strengths and limitations(a) this study provides support for long-term fatigue outcomes in people with a confirmed influenza, SARS, MERS, SARS-CoV2 virus infection (b) the study suggests individual, psychological and social factors are associated with fatigue, (c) findings are limited by the availability of fatigue data and lack of pre-morbid fatigue information; (d) a meta-analysis on the associations was prohibited by the small number of studies investigating long-term fatigue correlates and (e) the heterogeneity of the studies (>75%) suggests the pooled estimates should be interpreted with caution.

Analysis of Attitudes and Practices towards the Influenza Vaccine in High-Risk Adults in Poland

“…This forms the basis for considering the development of awareness programs for society regarding the safety profile of available vaccines, as well as the significant advantages of vaccination [ 28 ]. One of the most commonly reported mild adverse events was fatigue, which was also observed by the authors of other studies [ 29 , 30 ].…”

A Scoping Review of Pharmacological Management of Postacute Sequelae of Severe Acute Respiratory Syndrome Coronavirus 2 Infection in 2021

“…88 Fatigue is common after infection with other coronaviruses and influenza, with 1 study reporting 41% of participants experiencing fatigue after recovery from severe acute respiratory syndrome (SARS), Middle East respiratory syndrome, and influenza, in addition to SARS-CoV2. 89 In other studies, participants have reported symptoms of fatigue, myalgia, and psychiatric impairments for as long as 4 years after acute infection with Middle East respiratory syndrome and SARS. 28,[90][91][92] Six studies with available data assessed PASC symptoms of fatigue, among other symptoms.…”

Implications of Innate Immunity in Post-Acute Sequelae of Non-Persistent Viral Infections

“…For example, the acute phase of COVID-19 usually lasts two to four weeks, during which the virus is actively shed and the onset of post-acute sequelae is usually considered after week 5 [16]. IAV is usually cleared within 5-6 days in adults and post-acute symptoms may include chronic fatigue that has been reported up to six weeks post the initial infection [17]. Schematic overview of symptoms, virus load and inflammation levels in the pre-acute, acute and post-acute phase of a (non-persistent) viral infection.…”