Abstract
This study assessed the prevalence and determinants of fatigue in a population-based cohort of non-hospitalized subjects 1.5–6 months after COVID-19. It was a mixed postal/web survey of all non-hospitalized patients ≥18 years with a positive PCR for SARS-CoV-2 until 1 June 2020 in a geographically defined area. In total, 938 subjects received a questionnaire including the Chalder fatigue scale (CFQ-11) and the energy/fatigue scale of the RAND-36 questionnaire. We estimated z scores for comparison with general population norms. Determinants were analyzed using multivariable logistic and linear regression analysis. In total, 458 subjects (49%) responded to the survey at median 117.5 days after COVID-19 onset, and 46% reported fatigue. The mean z scores of the CFQ-11 total was 0.70 (95% CI 0.58 to 0.82), CFQ-11 physical 0.66 (0.55 to 0.78), CFQ-11 mental 0.47 (0.35 to 0.59) and RAND-36 energy/fatigue −0.20 (−0.31 to −0.1); all CFQ-11 scores differed from those of the norm population (p < 0.001). Female sex, single/divorced/widowed, short time since symptom debut, high symptom load, and confusion during acute COVID-19 were associated with higher multivariable odds of fatigue. In conclusion, the burden of post-viral fatigue following COVID-19 was high, and higher than in a general norm population. Symptoms of fatigue were most prevalent among women, those having a high symptom load, or confusion during the acute phase.
Highlights
Most patients with COVID-19 experience none or only minor upper respiratory symptoms, but respiratory symptoms, such as cough or dyspnea, and non-respiratory symptoms, such as fatigue, tiredness, sleepiness, and headache, are common during the acute phase of COVID-19 [1,2]
The subjects responded to the questionnaires a median 117.5 days (25th to 75th percentile 105–135, range 41–200) after first symptom of COVID-19
Fatigue was lower among males and higher with high symptom load and confusion during acute COVID-19 on three different fatigue scales
Summary
Most patients with COVID-19 experience none or only minor upper respiratory symptoms, but respiratory symptoms, such as cough or dyspnea, and non-respiratory symptoms, such as fatigue, tiredness, sleepiness, and headache, are common during the acute phase of COVID-19 [1,2]. During follow-up in survivors of other coronaviruses, such as severe acute respiratory syndrome (SARS), 64% reported fatigue at. Following Middle East respiratory syndrome (MERS), 48% had clinically relevant fatigue after 12 months [7]. There is considerable concern about long-term sequelae following COVID-19 and that the disease will trigger post-viral fatigue syndromes [8,9,10,11]. The prevalence of fatigue following hospitalization for COVID-19 ranges from 52 to 70% at 1–3 months after hospital discharge [12,13,14]. Non-hospitalized patients represent a larger patient group, the majority of emerging data concerns hospitalized patients
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