Dengue and post-infection fatigue: findings from a prospective cohort-the Colombo Dengue Study

Trans R Soc Trop Med Hyg. 2021 Jun 2;115(6):669-676. doi: 10.1093/trstmh/traa110.


Background: Previous studies on post-infection fatigue in dengue are few but suggest that up to 25% of dengue patients may suffer from fatigue. This study aimed to evaluate the prevalence and associations of post-infection fatigue in dengue patients compared with non-dengue fever patients.

Methods: Post-infection fatigue and its demographic and clinical associations were assessed in adult dengue and non-dengue fever patients 2 months after the acute infection in a prospective cohort study in Sri Lanka. Fatigue at 2 months (primary endpoint) was assessed with the fatigue questionnaire as a dichotomous outcome based on a pre-recommended cut-off (score ≥4) and as the total score from the questionnaire (higher score indicates more fatigue).

Results: Of 260 patients, 158 had dengue and, of these, 51 (32%) had fatigue at 2 months. Risk was higher in dengue patients (vs non-dengue; relative risk [RR] 4.93 [95% confidence interval {CI} 2.3 to 10.4]) and more so in female dengue patients (vs male dengue patients; RR 2.45 [95% CI 1.24 to 4.86]). Severe dengue patients had a higher mean fatigue score (p=0.024).

Conclusions: Post-infection fatigue is an underappreciated burden of this widely prevalent infection. Our findings are useful to triage patients at risk of fatigue for follow-up.

Keywords: Colombo Dengue Study; Sri Lanka; dengue; fatigue; post-infection fatigue.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cohort Studies
  • Dengue* / complications
  • Dengue* / epidemiology
  • Fatigue / epidemiology
  • Fatigue / etiology
  • Female
  • Humans
  • Male
  • Prospective Studies
  • Sri Lanka / epidemiology