TY - JOUR
T1 - Risk Factors and Multidimensional Assessment of Long Coronavirus Disease Fatigue
T2 - A Nested Case-Control Study
AU - Margalit, Ili
AU - Yelin, Dana
AU - Sagi, Moshe
AU - Rahat, Maya Merav
AU - Sheena, Liron
AU - Mizrahi, Nadav
AU - Gordin, Yael
AU - Agmon, Hadar
AU - Epstein, Nitzan Karny
AU - Atamna, Alaa
AU - Tishler, Ori
AU - Daitch, Vered
AU - Babich, Tanya
AU - Abecasis, Donna
AU - Yarom, Yoni
AU - Kazum, Shirit
AU - Shitenberg, Dorit
AU - Baltaxe, Erik
AU - Elkana, Odelia
AU - Shapira-Lichter, Irit
AU - Leibovici, Leonard
AU - Yahav, Dafna
N1 - Publisher Copyright:
© 2022 The Author(s). Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved.
PY - 2022/11/15
Y1 - 2022/11/15
N2 - Background: Fatigue is the most prevalent and debilitating long-COVID (coronavirus disease) symptom; however, risk factors and pathophysiology of this condition remain unknown. We assessed risk factors for long-COVID fatigue and explored its possible pathophysiology. Methods: This was a nested case-control study in a COVID recovery clinic. Individuals with (cases) and without (controls) significant fatigue were included. We performed a multidimensional assessment evaluating various parameters, including pulmonary function tests and cardiopulmonary exercise testing, and implemented multivariable logistic regression to assess risk factors for significant long-COVID fatigue. Results: A total of 141 individuals were included. The mean age was 47 (SD: 13) years; 115 (82%) were recovering from mild coronavirus disease 2019 (COVID-19). Mean time for evaluation was 8 months following COVID-19. Sixty-six (47%) individuals were classified with significant long-COVID fatigue. They had a significantly higher number of children, lower proportion of hypothyroidism, higher proportion of sore throat during acute illness, higher proportions of long-COVID symptoms, and of physical limitation in daily activities. Individuals with long-COVID fatigue also had poorer sleep quality and higher degree of depression. They had significantly lower heart rate [153.52 (22.64) vs 163.52 (18.53); P =. 038] and oxygen consumption per kilogram [27.69 (7.52) vs 30.71 (7.52); P =. 036] at peak exercise. The 2 independent risk factors for fatigue identified in multivariable analysis were peak exercise heart rate (OR:. 79 per 10 beats/minute; 95% CI:. 65-.96; P =. 019) and long-COVID memory impairment (OR: 3.76; 95% CI: 1.57-9.01; P =. 003). Conclusions: Long-COVID fatigue may be related to autonomic dysfunction, impaired cognition, and decreased mood. This may suggest a limbic-vagal pathophysiology. Clinical Trials Registration: NCT04851561.
AB - Background: Fatigue is the most prevalent and debilitating long-COVID (coronavirus disease) symptom; however, risk factors and pathophysiology of this condition remain unknown. We assessed risk factors for long-COVID fatigue and explored its possible pathophysiology. Methods: This was a nested case-control study in a COVID recovery clinic. Individuals with (cases) and without (controls) significant fatigue were included. We performed a multidimensional assessment evaluating various parameters, including pulmonary function tests and cardiopulmonary exercise testing, and implemented multivariable logistic regression to assess risk factors for significant long-COVID fatigue. Results: A total of 141 individuals were included. The mean age was 47 (SD: 13) years; 115 (82%) were recovering from mild coronavirus disease 2019 (COVID-19). Mean time for evaluation was 8 months following COVID-19. Sixty-six (47%) individuals were classified with significant long-COVID fatigue. They had a significantly higher number of children, lower proportion of hypothyroidism, higher proportion of sore throat during acute illness, higher proportions of long-COVID symptoms, and of physical limitation in daily activities. Individuals with long-COVID fatigue also had poorer sleep quality and higher degree of depression. They had significantly lower heart rate [153.52 (22.64) vs 163.52 (18.53); P =. 038] and oxygen consumption per kilogram [27.69 (7.52) vs 30.71 (7.52); P =. 036] at peak exercise. The 2 independent risk factors for fatigue identified in multivariable analysis were peak exercise heart rate (OR:. 79 per 10 beats/minute; 95% CI:. 65-.96; P =. 019) and long-COVID memory impairment (OR: 3.76; 95% CI: 1.57-9.01; P =. 003). Conclusions: Long-COVID fatigue may be related to autonomic dysfunction, impaired cognition, and decreased mood. This may suggest a limbic-vagal pathophysiology. Clinical Trials Registration: NCT04851561.
KW - post-COVID
KW - post-viral fatigue
UR - https://www.scopus.com/pages/publications/85135525557
U2 - 10.1093/cid/ciac283
DO - 10.1093/cid/ciac283
M3 - Article
C2 - 35403679
AN - SCOPUS:85135525557
SN - 1058-4838
VL - 75
SP - 1688
EP - 1697
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 10
ER -
