Fatigue and symptom-based clusters in post COVID-19 patients: a multicentre, prospective, observational cohort study

Merel E. B. Cornelissen, Lizan D. Bloemsma, Anouk W. Vaes, Nadia Baalbaki, Qichen Deng, Rosanne J. H. C. G. Beijers, Lieke C. E. Noij, Laura Houweling, Somayeh Bazdar, Martijn A. Spruit, Anke H. Maitland-van der Zee

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: In the Netherlands, the prevalence of post COVID-19 condition is estimated at 12.7% at 90–150 days after SARS-CoV-2 infection. This study aimed to determine the occurrence of fatigue and other symptoms, to assess how many patients meet the Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) criteria, to identify symptom-based clusters within the P4O2 COVID-19 cohort and to compare these clusters with clusters in a ME/CFS cohort. Methods: In this multicentre, prospective, observational cohort in the Netherlands, 95 post COVID-19 patients aged 40–65 years were included. Data collection at 3–6 months after infection included demographics, medical history, questionnaires, and a medical examination. Follow-up assessments occurred 9–12 months later, where the same data were collected. Fatigue was determined with the Fatigue Severity Scale (FSS), a score of ≥ 4 means moderate to high fatigue. The frequency and severity of other symptoms and the percentage of patients that meet the ME/CFS criteria were assessed using the DePaul Symptom Questionnaire-2 (DSQ-2). A self-organizing map was used to visualize the clustering of patients based on severity and frequency of 79 symptoms. In a previous study, 337 Dutch ME/CFS patients were clustered based on their symptom scores. The symptom scores of post COVID-19 patients were applied to these clusters to examine whether the same or different clusters were found. Results: According to the FSS, fatigue was reported by 75.9% of the patients at 3–6 months after infection and by 57.1% of the patients 9–12 months later. Post-exertional malaise, sleep disturbances, pain, and neurocognitive symptoms were also frequently reported, according to the DSQ-2. Over half of the patients (52.7%) met the Fukuda criteria for ME/CFS, while fewer patients met other ME/CFS definitions. Clustering revealed specific symptom patterns and showed that post COVID-19 patients occurred in 11 of the clusters that have been observed in the ME/CFS cohort, where 2 clusters had > 10 patients. Conclusions: This study shows persistent fatigue and diverse symptomatology in post COVID-19 patients, up to 12–18 months after SARS-CoV-2 infection. Clustering showed that post COVID-19 patients occurred in 11 of the clusters that have been observed in the ME/CFS cohort.
Original languageEnglish
Article number191
JournalJournal of translational medicine
Volume22
Issue number1
DOIs
Publication statusPublished - 1 Dec 2024

Keywords

  • Clusters
  • Fatigue
  • Long COVID
  • ME/CFS
  • Persistent symptoms
  • Post COVID-19 condition
  • Post-viral condition

Cite this