JMIR Publications

ABSTRACT

Background:

Fatigue is the most reported symptom in patients with persistent complaints following COVID-19 (i.e. long COVID). Longitudinal studies examining the intensity of fatigue and differentiating between physical and mental fatigue are lacking.

Objective:

Therefore, this study was conducted with the following objectives: (1) to assess the severity of fatigue over time in members of online long COVID peer support groups, and (2) to assess whether members of online long COVID peer support groups experience mental fatigue, physical fatigue or both.

Methods:

A two-wave web-based follow-up study was conducted in members of online long COVID peer support groups with a confirmed diagnosis approximately three and six months after the onset of infectious symptoms. Demographics, COVID-19 diagnosis, received healthcare (medical professions and/or allied healthcare professionals), fatigue (Checklist Individual Strength – subscale subjective fatigue, CIS-Fatigue; 8-56 points), and physical and mental fatigue (self-constructed questions; 3-21 points) were assessed. Higher scores indicate more severe fatigue. A CIS-Fatigue score ≥36 points was used to determine severe fatigue.

Results:

239 patients with PCR/CT confirmed COVID-19 (83% women; median [IQR] age: 50 [39-56] years; 60% no self-reported pre-existing comorbidities; 87% good self-reported health before COVID-19; 26% hospitalized during acute infection) filled out the survey 10±2 and 23±2 weeks after onset of infectious symptoms, respectively T1 and T2. The vast majority of patients had severe fatigue at T1 and T2 (85% and 79%, respectively). No significant differences were found in the prevalence of fatigue between T1 and T2 (P=.12). Median CIS-Fatigue was 48 [42-53] points at T1 and decreased from T1 to T2 (median change: -2 [-7 to 3] points, P<.001). At T1, a median physical fatigue of 19 [16-20] points and mental fatigue of 15 [10-17] points was reported, which was lower at T2 for physical but not mental fatigue (median change: -1 [-3 to 0], P<.001; and 0 [-3 to 3] points, P=.52, respectively). At time of completing the follow-up survey, 81% and 69% of all patients had received care from at least one medical profession and allied healthcare professional, respectively.

Conclusions:

Fatigue in members of online long COVID support groups with a confirmed COVID-19 diagnosis decreases from 10 to 23 weeks after onset of symptoms. Despite this, severe fatigue remains highly prevalent. Both physical and mental fatigue are present. It remains unclear whether fatigue will resolve spontaneously on the longer term. Clinical Trial: Netherlands Trial Register NTR8705