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Persistent fatigue following SARS-CoV-2 infection is common and independent of severity of initial infection July 2020 Townsend et al

Discussion in 'Epidemics (including Covid-19)' started by Sly Saint, Jul 31, 2020 at 11:37 AM.

  1. Sly Saint

    Sly Saint Senior Member (Voting Rights)

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    Preprint
    https://www.medrxiv.org/content/10.1101/2020.07.29.20164293v1
     
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  2. Sly Saint

    Sly Saint Senior Member (Voting Rights)

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    Uses Chalder fatigue scale.
    here we go again.
     
  3. Aslaug

    Aslaug Senior Member (Voting Rights)

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    Did they at least correct for the anxious/depression that would increase scores on the CFQ..?
     
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  4. Trish

    Trish Moderator Staff Member

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    I have tweeted one of the authors:



     
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  5. Dolphin

    Dolphin Senior Member (Voting Rights)

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  6. obeat

    obeat Senior Member (Voting Rights)

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  7. Tom Kindlon

    Tom Kindlon Senior Member (Voting Rights)

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    Thanks for highlighting it to me. I think I will be cautious about criticising the researchers publicly at this stage given my work with the Irish ME/CFS Association and that we may wish to work with them at some stage (there has been very little biomedical ME/CFS research ever in the Republic of Ireland)
     
    Last edited: Jul 31, 2020 at 2:49 PM
  8. cassava7

    cassava7 Senior Member (Voting Rights)

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  9. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

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    Many thanks for your very helpful feedback. Apologies if it seems as though we are proposing graded exercise for all; we mean to suggest a suite of interventions that will need to be individually tailored, rather than a blanket approach to all. Will clarify in published version.

    So how do they know how to tailor interventions? Without any trials? He says he may identify a group worthy of further study and early intervention so what is the suite he prepare earlier?

    Nul points I am afraid.
     
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  10. Trish

    Trish Moderator Staff Member

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    They have replied to my tweet saying they are aware of the limitations of the CFQ, but don't know of any better measure of fatigue.

    Can someone suggest a better one for me to suggest to them, especially if they are using it for ongoing follow up of patients post treatment, as they need one that allows for worsening to show, and doesn't have the CFQ ceiling effect.
     
  11. strategist

    strategist Senior Member (Voting Rights)

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    That fatigue is independent of infection severity seems unintuitive. Could this be due to inadequacies of the Chalder scale? Or is this a hint that fatigue is due to a somewhat different process than the infection, triggered by it but then continuing on its own?

    Anyway I'm troubled by the observation that GET and CBT are still seen as important treatment for fatigue, including the authors of this paper. There is no good reason to think they work any better than a placebo. I also don't like the eagerness of the authors to intervene early. They appear convinced that they know how to help patients and don't seem to consider the possibility that they could cause harm by acting without having any real understanding of the problem. Making patients jump through extra hoops with the intent of helping them recover could delay or prevent their recovery.
     
    Last edited: Jul 31, 2020 at 4:28 PM
  12. Dolphin

    Dolphin Senior Member (Voting Rights)

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    Last edited: Jul 31, 2020 at 4:53 PM
  13. Snow Leopard

    Snow Leopard Senior Member (Voting Rights)

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    Depression/Anxiety was based on prior diagnoses or use of antidepressant medication.

    The real problem is that caseness was based on the aforementioned crap questionnaire.

    Notably, 86.6% of "Fatigued" participants did not have any prior depression/anxiety diagnoses, so this a weak predictor at most.
     
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  14. rvallee

    rvallee Senior Member (Voting Rights)

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    Oh, come on. Be serious here or be gone.
     
  15. rvallee

    rvallee Senior Member (Voting Rights)

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    There are many better tools than CFQ. None are great but this is a disappointing answer, it's pretty much the worst one. Is it really the job of patients to point out to researchers that there are other tools? Did they simply not look? Over the years from papers I have seen several in use that are much better. Ugh.

    Great replies everyone, though. But really using only one and the worst one of all? I repeat myself but: ugh.
     
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  16. adambeyoncelowe

    adambeyoncelowe Senior Member (Voting Rights)

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    There are a bunch. Checklist Individual Strength, maybe? Fatigue Severity Scale? Any are better than the CFQ, I think, though all have problems.
     
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  17. Snow Leopard

    Snow Leopard Senior Member (Voting Rights)

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    I think they were already using the CFQ in their clinic and this is just a rushed study...
     
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  18. Trish

    Trish Moderator Staff Member

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    Oh dear. I think the next link to offer them is to Mark Vink's latest paper deconstructing Cochrane and focusing on return to work.
     
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  19. cassava7

    cassava7 Senior Member (Voting Rights)

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    Actually, they do cite the latter...
    Not sure they read it!
     
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  20. Trish

    Trish Moderator Staff Member

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    That was a previous paper. I've sent a link to Vink's latest paper.


     
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