Post-COVID-19 Fatigue: Potential Contributing Factors

Abstract

Much of the spotlight for coronavirus disease 2019 (COVID-19) is on the acute symptoms and recovery. However, many recovered patients face persistent physical, cognitive, and psychological symptoms well past the acute phase. Of these symptoms, fatigue is one of the most persistent and debilitating. In this “perspective article,” we define fatigue 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 and propose a model to explain potential factors contributing to post-COVID-19 fatigue. According to our model, fatigue is dependent on conditional and physiological factors. Conditional dependency comprises the task, environment, and physical and mental capacity of individuals, while physiological factors include central, psychological, and peripheral aspects. This model provides a framework for clinicians and researchers. However, future research is needed to validate our proposed model and elucidate all mechanisms of fatigue due to COVID-19.

Long-Term Brain Disorders in Post Covid-19 Neurological Syndrome (PCNS) Patient

“…Post-COVID clinical manifestations. About one third of positive patients develop neurological and neuropsychiatric symptoms, generally in the early stages of the disease, but sometimes even after the resolution of the respiratory symptoms [ 4 ]. The most common symptoms appearing post-infection are anosmia, ageusia or dysgeusia, headache, muscle and joint pain, fatigue and mental fog, symptoms that can last for weeks or months [ 4 ].…”

“…About one third of positive patients develop neurological and neuropsychiatric symptoms, generally in the early stages of the disease, but sometimes even after the resolution of the respiratory symptoms [ 4 ]. The most common symptoms appearing post-infection are anosmia, ageusia or dysgeusia, headache, muscle and joint pain, fatigue and mental fog, symptoms that can last for weeks or months [ 4 ]. In severe cases, the infection can also lead to delirium and psychosis, inflammatory syndromes (such as encephalitis and acute disseminated encephalomyelitis), ischemic and hemorrhagic strokes [ 4 , 5 , 6 , 7 ].…”

“…The most common symptoms appearing post-infection are anosmia, ageusia or dysgeusia, headache, muscle and joint pain, fatigue and mental fog, symptoms that can last for weeks or months [ 4 ]. In severe cases, the infection can also lead to delirium and psychosis, inflammatory syndromes (such as encephalitis and acute disseminated encephalomyelitis), ischemic and hemorrhagic strokes [ 4 , 5 , 6 , 7 ]. Many causes are at the basis of the neurological manifestations of COVID-19 being a direct effect of the coronavirus on the nervous system or immune-mediated effects linked to para-infectious or post-infectious mechanisms [ 7 , 8 , 9 , 10 ].…”

Health Complications in Patients Recovering from COVID-19: A Narrative Review of Post-COVID Syndrome

“…High rates of post-viral fatigue have also been reported in patients recovering from Ebola virus infection [22]. Thus, it is not surprising that CFS is the most common symptom of COVID-19 [7,[23][24][25]. Fatigue is experienced by a substantial percentage of individuals who have recovered from COVID-19 infection [24], with 71.0% to 87.4% of patients reporting fatigue or shortness of breath two-three months after full recovery from infection [25].…”

“…Despite the prevalence of fatigue symptoms throughout the clinical population, the etiology of fatigue in relation to COVID-19 infections remains largely unknown. Some studies have demonstrated that women are more prone to experiencing long-term fatigue following COVID-19 recovery [23]. Patients with co-existing depression or anxiety also suffer from post-COVID fatigue longer than healthy individuals without psychiatric conditions [15,26].…”