Post-COVID-19 syndrome: Physical capacity, fatigue and quality of life

Abstract

Purpose Post-Covid-19 syndrome is defined as the persistence of symptoms beyond 3 months after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The most common symptoms include reduced exercise tolerance and capacity, fatigue, neurocognitive problems, muscle pain and dyspnea. The aim of our work was to investigate exercise capacity and markers of subjective wellbeing and their independent relation to post-COVID-19 syndrome. Patients and methods We examined a total of 69 patients with post-COVID-19 syndrome (23 male/46 female; age 46±12 years; BMI 28.9±6.6 kg/m2) with fatigue and a score ≥22 in the Fatigue Assessment Scale (FAS). We assessed exercise capacity on a cycle ergometer, a 6-minute walk test, the extent of fatigue (FAS), markers of health-related quality of life (SF-36 questionnaire) and mental health (HADS). Results On average the Fatigue Assessment Scale was 35.0±7.4 points. Compared with normative values the VO2max/kg was reduced by 8.6±5.8 ml/min/kg (27.7%), the 6MWT by 71±96 m (11.9%), the health-related quality of life physical component score by 15.0±9.0 points (29.9%) and the mental component score by 10.6±12.8 points (20.6%). Subdivided into mild fatigue (FAS score 22–34) and severe fatigue (FAS score ≥35), patients with severe fatigue showed a significant reduction of the 6-minute walk test by 64±165 m (p<0.01) and the health-related quality of life physical component score by 5.8±17.2 points (p = 0.01). In multiple regression analysis age (β = –0.24, p = 0.02), sex (β = 0.22, p = 0.03), mental (β = –0.51, p<0.01) and physical (β = –0.44, p<0.01) health-related quality of life and by trend the 6-minute walk test (β = –0.22, p = 0.07) were associated with the FAS. Conclusion Patients with post-COVID-19 syndrome show reduced maximal and submaximal physical performance as well as limitations in quality of life, particularly pronounced in the physical components. These results are essentially influenced by the severity of fatigue and implicating the need for targeted treatments.

Prevalences and Interrelationships of Post COVID-19 Fatigue, Sleep Disturbances, and Depression in Healthy Young and Middle-Aged Adults

“…Post-COVID-19 conditions is distinguished by its prolonged duration and diverse array of symptoms compared to other respiratory illnesses, such as influenza infection, despite exhibiting a similar prevalence of symptoms compared to other respiratory virus infections [3][4][5][6]. Fatigue and neuropsychiatric manifestations, such as sleep disturbances, anxiety, and depression, are the most frequently reported symptoms [7][8][9][10]; these symptoms significantly impair patient quality of life and ability to return to work [11][12][13][14][15][16]. Working individuals are particularly susceptible to long-term effects [17][18][19].…”

The Prevalence and Associated Factors of Post-COVID-19 Fatigue: A Systematic Review and Meta-Analysis

“…Many experts have pointed out that the occurrence of fatigue symptoms often leads to a reduction in physical performance, and a decrease in quality of life, and may even cause a series of complications. Multiple studies [ 12 , 13 ] have verified that post-COVID-19 fatigue is likely to result in late-onset pain, decreased exercise capacity, insomnia, and post-exertional malaise [ 14 ]. We should give post-COVID-19 fatigue enough attention because it may be detrimental to people's health and quality of life [ 15 ].…”