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Prognostic factors for persistent fatigue after COVID-19: a prospective matched cohort study in primary care 2023, Konig et al

Discussion in 'Psychosomatic research - ME/CFS and Long Covid' started by Sly Saint, Feb 7, 2023.

  1. Sly Saint

    Sly Saint Senior Member (Voting Rights)

    Background Persistent fatigue after COVID-19 is common; however, the exact incidence and prognostic factors differ between studies. Evidence suggests that age, female sex, high body mass index, and comorbidities are risk factors for long COVID.

    Aim To investigate the prevalence of persistent fatigue after COVID-19 in patients with a mild infection (managed in primary care) during the first wave of the pandemic and to determine prognostic factors for persistent fatigue.

    Design and setting This was a prospective cohort study in Dutch general practice, combining online questionnaires with data from electronic health records.

    Method Patients who contacted their GP between March and May 2020 and were diagnosed with COVID-19 during the first wave of the pandemic were included. Patients were matched to controls without COVID-19 based on age, sex, and GP practice. Fatigue was measured at 3, 6, and 15 months, using the Checklist of Individual Strength.

    Results All the participants were GP attendees and included 179 with suspected COVID-19, but who had mild COVID and who had not been admitted to hospital with COVID, and 122 without suspected COVID-19. Persistent fatigue was present in 35% (49/142) of the suspected COVID-19 group and 13% (14/109) of the non-COVID-19 group (odds ratio 3.65; 95% confidence interval = 1.82 to 7.32). Prognostic factors for persistent fatigue included low education level, absence of a partner, high neuroticism (using the Eysenck Personality Questionnaire Revised-Short Form), low resilience, high frequency of GP contact, medication use, and threatening experiences in the past. The latter three factors appeared to be prognostic factors for persistent fatigue specifically after COVID-19 infection.

    Conclusion GP patients with COVID-19 (who were not admitted to hospital with COVID) have a fourfold higher chance of developing persistent fatigue than GP patients who had not had COVID-19. This risk is even higher in psychosocially vulnerable patients who had COVID-19.

  2. rvallee

    rvallee Senior Member (Voting Rights)

  3. CRG

    CRG Senior Member (Voting Rights)

    For those not up to date why :facepalm: :
    Misconduct allegations push psychology hero off his pedestal

    "One of Anthony Pelosi's most ambitious projects was on the back burner for more than 2 decades. In the early 1990s, Pelosi, a psychiatrist at Priory Hospital Glasgow, published two extensive critiques of the work of Hans Eysenck, a giant of 20th century psychology. Eysenck's papers contained questionable data and results so dramatic they beggared belief, Pelosi concluded. His critiques, and those by several others, were widely discussed in the field, but never led to formal investigations. Buried by the demands of clinical practice, research, and a young family, Pelosi never found the time to continue his effort. No one, he says, "picked up the baton."

    More at link: https://www.science.org/content/article/misconduct-allegations-push-psychology-hero-his-pedestal
    RedFox, Peter Trewhitt, Sean and 4 others like this.
  4. hibiscuswahine

    hibiscuswahine Senior Member (Voting Rights)

    It’s always a worry when GP’s start doing psychological research and publishing it in the BMJ/GP edition.

    Though I am sure they have a few psychologists on their research team to help them with their assessment tools.

    Though probably also consulted with a few BPS psychiatry/academic departments, who said go for it….

    Personality factor testing before getting treated for your LC symptoms by your GP practice? Certainly sounds like it.
    Last edited: Feb 10, 2023
    RedFox, Peter Trewhitt, CRG and 3 others like this.
  5. Sean

    Sean Moderator Staff Member

    Pretty sure that Anthony Pelosi has been a significant figure in the psychologising of ME.

    Apparently lessons have not been learned.
  6. CRG

    CRG Senior Member (Voting Rights)

    Must admit I didn't recognise Pelosi's name before I posted above. I found seven papers where he is co-author including with Wessely and Deary, between 1988 and 1995 which mentions either CFS or PFS - the last of these: Chronic Fatigue Syndrome in the Community Prevalence and Associations Lawrie & Pelosi, 1995 in the abstract says:

    Chronic fatigue syndrome (CFS) is a poorly understood condition, apparently related to both psychiatric disturbance and infectious illness. Little progress has been made in identifying aetiology, owing to a lack of epidemiological studies using case-definition criteria.

    A community postal survey of a random sample of over 1000 patients registered at a local health centre comprised a fatigue questionnaire and the 12-item General Health Questionnaire(GHQ).

    Total fatigue scores were modestly higher in women than men. Fatigue was most frequently attributed to psychosocial factors. Fatigue and GHQ scores were strongly correlated. Two men and two women satisfied British criteria for CFS, a prevalence of 0.56% (95% Cl 0.16-1.47%); three were probable psychiatric cases.

    Conclusions. Previously reported socio-demographic associations of CFS may reflect medical referral patterns. A strong association exists with psychological morbidity, but relabelling CFS
    as a psychiatric disorder is not justified.

    My bolding.
    Sean, RedFox, Peter Trewhitt and 2 others like this.
  7. duncan

    duncan Senior Member (Voting Rights)

    Also, high education level, multiple partners, fans of Ann Rice, stubborn people, men who are fond of bow ties, woman who are fond of bow ties, low frequency of GP contact, people who enlist in the armed services, draft dodgers, and everyone from the US state of New Jersey.

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