Fatigue in post COVID-19 patients: the P4O2 COVID-19 study, 2023, Maitland-Van der Zee et al

Fatigue in post COVID-19 patients: the P4O2 COVID-19 study

Abstract
Background: Some patients do not fully recover after COVID-19 and have symptoms occurring 3 months after acute illness, lasting for >2 months, defined as post COVID-19. Fatigue seems most present in post COVID-19 and part of the patients might develop symptoms similar to chronic fatigue syndrome.

Aim: To determine the occurrence of fatigue and other symptoms in post COVID-19 patients.

Methods: In the prospective P4O2 COVID-19 cohort, post COVID-19 patients aged 40-65 years were recruited from outpatient post-COVID clinics in 5 Dutch hospitals between May 2021-September 2022. At 3-6 months post-COVID, patients completed the Fatigue Severity Scale (FSS). If the FSS score was ≥4 (the cut-off for severe fatigue), patients also completed the DePaul Symptom Questionnaire version 2 (DSQ-2). The FSS ranges from 1-7 and a higher score means more fatigued. The DSQ-2 rates frequency and severity of 79 symptoms on a 5-point Likert scale. Binary thresholds (if scored ≥2 on both severity and frequency, the threshold is met and the symptom is present) were calculated.

Results: The mean age of the 78 included patients was 53.9±6.2 and 51.7% were male. Median (IQR) FSS score was 5.6 (4.2-6.3) and 66 patients (84.6%) had a score ≥4. According to the DSQ-2 (n=61), patients reported a median (IQR) of 16 (8-23) symptoms. The majority of the patients experienced fatigue (85%). Furthermore, post-exertional malaise (PEM) (40%), sleep-related problems (37%), pain (21%) and neurocognitive problems (23%) were frequently reported.

Conclusion: The occurrence of severe fatigue 3-6 months after COVID-19 was 84.6% in our cohort. Patients with severe fatigue also frequently reported PEM, sleep related problems, pain and neurocognitive problems.

https://erj.ersjournals.com/content/62/suppl_67/PA4574

 

This is a conference abstract. To the mods: Would it be possible to add "conference abstract" or something similar as tag?

I've added this work since Maitland-van der Zee recently received a grant to do LC research in the Netherlands. Some of her other work includes

• Identification of long COVID phenotypes based on clinical presentation at 3 to 6 months post SARS-CoV-2 infection: results from the P4O2 consortium
• Clinical-Based Phenotypes in Children with Pediatric Post-COVID Condition
• First study results of the P4O2 long COVID cohort
• LSC - 2023 - Activated -inflammatory states of airway cells in Long COVID

 

So great that because the widespread denial continues, going on 4 years we're still stuck with small research confirming things that were obvious by the summer of 2020 by simply paying attention.

And it really does have to be confirmed, because it's still denied anyway. So there has to be a mass that not only shows the scope, but makes it impossible to simply argue "yes, yes, but it will go away magically soon", and we are not nearly there yet. Probably for as long as every wave gets called the last one, and how herd immunity is just right around the corner, just one more infection for everyone ought to do it.

This all kind of feels like the old model of village elders ignoring all the warnings before their society crumbles. But way more expensive. And even more reactionary. Somehow.

 

Yes, on the other hand for the above paper, since it's a large majority of elderly males that have only been sick for a shorter time period (<6 months), I expect that the majority of them will probably have self-resolved fatigue as typical for many viral infections. Unless your goal is to accompany such a study with a long-term follow-up, reporting on fatigue and PEM after less then 6 months in relation to ME/CFS seems somewhat meaningless. After all the minimum duration of 6 months of symptoms in the CCC exists for a reason.

 

Thank you. Yes, that's what I meant.