Review: Assessment and management of post‐COVID fatigue, 2021, Gaber

[Wyva]

Assessment and management of post‐COVID fatigue

Abstract
Post‐viral fatigue is the most common long‐term health issue facing survivors of COVID‐19, according to initial reports. Here, Dr Gaber discusses the risk, diagnosis and principles of management of post‐viral fatigue and its chronic variant – myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) –within the context of the pandemic and highlights that further research is urgently needed to guide clinical practice.


As an acute viral pneumonia, COVID‐19 has an estimated mortality of less than 1% (although this rises steeply in people aged over 80 years) but the sheer scale of the pandemic converted that relatively small percentage to more than a million fatalities globally.1 The tens of millions of survivors of the disease may face the risk of other long‐term health issues. Initial reports suggest that post‐viral fatigue is the most common long‐term health issue facing survivors of the disease.2 In this review the risk, diagnosis and principles of management of post‐viral fatigue and its chronic variant – myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) – will be discussed within the context of the current pandemic.

It starts alright but then comes up with BPS and CBT and maladaptive behaviours. Is it only me or has the BPS school intensified their efforts to go after post-covid in the past week or so?

https://wchh.onlinelibrary.wiley.com/doi/full/10.1002/pnp.698

 

[Mij]

I feel it starts out poorly by mentioning ME/CFS and PEM. These articles continue to undermine ME, and bunch it up with post fatigue states.

"Post‐exertional malaise is an extremely common feature and it is often associated with other immunological manifestations such as persistent sore throat or lymphadenopathy".

 

[Sphyrna]

"Psychological distress during the acute and subacute phase of the viral infection is another strong risk factor for long‐term fatigue.9 "

Ok, cool, let's check out what Jason, Katz, Shiraishi, et al in "Predictors of Post‐Infectious Chronic Fatigue Syndrome in Adolescents" have to say about this.

From the abstract: "A number of variables were predictors of post-infectious CFS at six months; however, when autonomic symptoms were used as a control variable, only days spent in bed since mono was a significant predictor. Step-wise logistic regression findings indicated that baseline autonomic symptoms as well as days spent in bed since mono, which reflect the severity of illness, were the only significant predictors of those who met CFS criteria at six months."

Sorry, maybe I'm missing something, but I already lost all interest in reading the rest. I guess one could make the argument that controlling for ANS symptoms is like controlling Mount Everest for height and saying it's warm up there, but I still think citing it this way doesn't bode well for the rest of the paper.