TY - JOUR
T1 - Severe Fatigue in the First Year Following SARS-CoV-2 Infection
T2 - A Prospective Cohort Study
AU - Verveen, Anouk
AU - Wynberg, Elke
AU - van Willigen, Hugo D. G.
AU - Boyd, Anders
AU - de Jong, Menno D.
AU - de Bree, Godelieve
AU - Davidovich, Udi
AU - Lok, Anja
AU - Moll van Charante, Eric P.
AU - Knoop, Hans
AU - Prins, Maria
AU - Nieuwkerk, Pythia
AU - Agard, Ivette
AU - Ayal, Jane
AU - Cavdar, Floor
AU - Craanen, Marianne
AU - Deuring, Annemarieke
AU - van Dijk, Annelies
AU - Ersan, Ertan
AU - del Grande, Laura
AU - Hartman, Joost
AU - Koedoot, Nelleke
AU - Leenstra, Tjalling
AU - Lebbink, Romy
AU - Loomans, Dominique
AU - Makowska, Agata
AU - du Maine, Tom
AU - de Man, Ilja
AU - Matser, Amy
AU - van der Meij, Lizenka
AU - van Polanen, Marleen
AU - Oud, Maria
AU - Reid, Clark
AU - Storey, Leeann
AU - van Wijk, Marc
AU - van den Aardweg, Joost
AU - van Assem, Joyce
AU - van Beek, Marijne
AU - Blankert, Thyra
AU - Dijkstra, Maartje
AU - Figaroa, Orlane
AU - Frenkel, Leah
AU - van Gils, Marit
AU - van Haga, Jelle
AU - Han, Xiaochuan
AU - Harskamp-Holwerda, Agnes
AU - Hazenberg, Mette
AU - Hidad, Soemeja
AU - de Jong, Nina
AU - Kootstra, Neeltje
AU - Kuijt, Lara
AU - Russell, Colin
AU - van der Straten, Karlijn
AU - van der Veen, Annelou
AU - Verkaik, Bas
AU - Visser, Gerben-Rienk
N1 - Publisher Copyright: © 2022 The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America.
PY - 2022/5/1
Y1 - 2022/5/1
N2 - Background: Severe fatigue can persist for months after coronavirus disease 2019 (COVID-19) onset. This longitudinal study describes fatigue severity and its determinants up to 12 months after illness onset across the full spectrum of COVID-19 severity. Methods: RECoVERED, a prospective cohort study in Amsterdam, the Netherlands, enrolled participants aged≥16 years after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) diagnosis. Fatigue was measured using the validated Short Fatigue Questionnaire (SFQ; range 4-28) at months 1, 3, 6, 9, and 12 of follow-up. Fatigue severity was modeled over time using mixed-effects linear regression. Determinants of severe fatigue (SFQ≥18) at 6 months since illness onset (ie, persistent fatigue) were identified using logistic regression. Results: Between May 2020 and July 2021, 303 participants completed at least 1 fatigue questionnaire. Twelve months after illness onset, 17.4% (95% CI, 6.7% to 38.3%), 21.6% (95% CI, 11.2% to 37.7%), and 44.8% (95% CI, 28.0% to 62.9%) of participants with mild, moderate, and severe/critical COVID-19 (World Health Organization definition), respectively, experienced severe fatigue. When adjusting for age and sex, having≥3 comorbidities (P=.007), severe/critical COVID-19 (P=.002), low mood (P<.001), and dyspnea in the first 2 weeks of illness (P=.001) were associated with more severe fatigue over time. Severe/critical COVID-19 (adjusted odds ratio [aOR], 3.37; 95% CI, 1.28 to 8.93) and low mood at enrollment (aOR, 2.43; 95% CI, 1.11 to 5.29) were associated with persistent fatigue. Recovery rarely occurred beyond 6 months after illness onset, regardless of COVID-19 severity. Conclusions: The occurrence of severe fatigue in our cohort was high, especially among those with initially severe/critical COVID-19, with little recovery beyond 6 months after illness onset. Our findings highlight an urgent need for improved understanding of persistent severe fatigue following COVID-19 to help inform prevention and intervention.
AB - Background: Severe fatigue can persist for months after coronavirus disease 2019 (COVID-19) onset. This longitudinal study describes fatigue severity and its determinants up to 12 months after illness onset across the full spectrum of COVID-19 severity. Methods: RECoVERED, a prospective cohort study in Amsterdam, the Netherlands, enrolled participants aged≥16 years after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) diagnosis. Fatigue was measured using the validated Short Fatigue Questionnaire (SFQ; range 4-28) at months 1, 3, 6, 9, and 12 of follow-up. Fatigue severity was modeled over time using mixed-effects linear regression. Determinants of severe fatigue (SFQ≥18) at 6 months since illness onset (ie, persistent fatigue) were identified using logistic regression. Results: Between May 2020 and July 2021, 303 participants completed at least 1 fatigue questionnaire. Twelve months after illness onset, 17.4% (95% CI, 6.7% to 38.3%), 21.6% (95% CI, 11.2% to 37.7%), and 44.8% (95% CI, 28.0% to 62.9%) of participants with mild, moderate, and severe/critical COVID-19 (World Health Organization definition), respectively, experienced severe fatigue. When adjusting for age and sex, having≥3 comorbidities (P=.007), severe/critical COVID-19 (P=.002), low mood (P<.001), and dyspnea in the first 2 weeks of illness (P=.001) were associated with more severe fatigue over time. Severe/critical COVID-19 (adjusted odds ratio [aOR], 3.37; 95% CI, 1.28 to 8.93) and low mood at enrollment (aOR, 2.43; 95% CI, 1.11 to 5.29) were associated with persistent fatigue. Recovery rarely occurred beyond 6 months after illness onset, regardless of COVID-19 severity. Conclusions: The occurrence of severe fatigue in our cohort was high, especially among those with initially severe/critical COVID-19, with little recovery beyond 6 months after illness onset. Our findings highlight an urgent need for improved understanding of persistent severe fatigue following COVID-19 to help inform prevention and intervention.
KW - COVID-19
KW - fatigue
KW - infection
KW - persistence
KW - predictors
UR - http://www.scopus.com/inward/record.url?scp=85128738504&partnerID=8YFLogxK
U2 - https://doi.org/10.1093/ofid/ofac127
DO - https://doi.org/10.1093/ofid/ofac127
M3 - Article
C2 - 35415196
SN - 2328-8957
VL - 9
JO - Open forum infectious diseases
JF - Open forum infectious diseases
IS - 5
M1 - ofac127
ER -