Fatigue has a prominent impact on health lasting 12-weeks after COVID-19 infection

Malawi Med J. 2023 Jun;35(2):124-129. doi: 10.4314/mmj.v35i2.9.

Abstract

Background: While the amount of information on many issues related to COVID-19 has increased, the long-term consequences of illness and disability remain largely unclear. In previous studies on COVID-19 infections, long-lasting functional and symptomatic abnormalities have also been shown. It is predicted that survivors of COVID-19 may have to deal with physical or psychological problems later.

Aim: We aimed to evaluate long-lasting symptoms including fatigue and investigate the associated risk factors.

Methods: In this prospective cohort study, 132 consecutive COVID-19 patients who were previously diagnosed and admitted 13±1 weeks after diagnosis were included. The Functional Assessment of Chronic Illness Therapy (FACIT) - Fatigue Scale, the Beck Anxiety Inventory, the Beck Depression Inventory, and the Lawton Instrumental Activities of Daily Living (IADL) Scale were applied in the follow-up visit.

Results: The median age of the patients (76 male, 56 female) was 52. Eighty (61%) of the patients were hospitalized, while 52 (39%) of them were not hospitalized. At least one symptom persisted in 103 (78%) patients, with fatigue (n=48, 36%) being the most common symptom. Both dyspnea and fatigue were more prominent in women than in men (34% vs. 11%, p=0.001 and 46% vs 29%, p=0.03; respectively). Persisted symptoms including fatigue were not significantly associated with hospitalization status. The FACIT scores of the patients at 12 weeks were positively associated with their depression and anxiety levels (R: 0.55, p=0.0001 and R: 0.42, p=0.0001), while they were negatively associated with their IADL scores (R: -0.25, p=0.004).

Conclusions: Fatigue was the most frequent persistent symptom. The initial fatigue scores were higher in the severely ill patients. Persistent fatigue was not associated with disease severity but was closely associated with anxiety and depression.

Keywords: COVID-19; fatigue; pandemic; persistent symptoms; risk factors.

MeSH terms

  • Activities of Daily Living*
  • Anxiety
  • COVID-19*
  • Fatigue
  • Female
  • Humans
  • Male
  • Prospective Studies