Long COVID and Post-infective Fatigue Syndrome: A Review

Abstract Fatigue is a dominant feature of both acute and convalescent coronavirus disease 2019 (COVID-19) (sometimes termed “long-COVID”), with up to 46% of patients reporting fatigue that lasts from weeks to months. The investigators of the international Collaborative on Fatigue Following Infection...

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Bibliographic Details
Published in:Open forum infectious diseases Vol. 8; no. 10; p. ofab440
Main Authors: Sandler, Carolina X, Wyller, Vegard B B, Moss-Morris, Rona, Buchwald, Dedra, Crawley, Esther, Hautvast, Jeannine, Katz, Ben Z, Knoop, Hans, Little, Paul, Taylor, Renee, Wensaas, Knut-Arne, Lloyd, Andrew R
Format: Journal Article
Language:English
Published: US Oxford University Press 01.10.2021
Subjects:
Cohort analysis
Coronaviruses
COVID-19
Editor's Choice
Review
COVID-19
assessment
fatigue
post-viral
cohorts
ISSN:2328-8957, 2328-8957
Online Access:Get full text
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Summary:Abstract Fatigue is a dominant feature of both acute and convalescent coronavirus disease 2019 (COVID-19) (sometimes termed “long-COVID”), with up to 46% of patients reporting fatigue that lasts from weeks to months. The investigators of the international Collaborative on Fatigue Following Infection (COFFI) conducted a systematic review of post-COVID fatigue and a narrative review on fatigue after other infections, and made recommendations for clinical and research approaches to assessing fatigue after COVID-19. In the majority of COVID-19 cohort studies, persistent fatigue was reported by a significant minority of patients, ranging from 13% to 33% at 16–20 weeks post-symptom onset. Data from the prospective cohort studies in COFFI and others indicate that fatigue is also a prevalent outcome from many acute systemic infections, notably infectious mononucleosis, with a case rate for clinically significant Post-infective fatigue after exclusion of recognized medical and psychiatric causes, ranging from 10%–35% at 6 months. To better characterize post-COVID fatigue, the COFFI investigators recommend the following: application of validated screening questionnaires for case detection; standardized interviews encompassing fatigue, mood, and other symptoms; and investigative approaches to identify end-organ damage and mental health conditions. Fatigue after COVID-19 is common but generally resolves over months, like other postinfective fatigue states. Post-COVID fatigue results from end-organ injury, mental health conditions, or idiopathic post-COVID fatigue. Post-COVID fatigue should be assessed with validated questionnaires, interviews, and protocolized investigations.
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ISSN:2328-8957
2328-8957
DOI:10.1093/ofid/ofab440