Persistent fatigue following SARS-CoV-2 infection is common and independent of severity of initial infection

Fatigue is a common symptom in those presenting with symptomatic COVID-19 infection. However, it is unknown if COVID-19 results in persistent fatigue in those recovered from acute infection. We examined the prevalence of fatigue in individuals recovered from the acute phase of COVID-19 illness using...

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Vydáno v:	PloS one Ročník 15; číslo 11; s. e0240784
Hlavní autoři:	Townsend, Liam, Dyer, Adam H., Jones, Karen, Dunne, Jean, Mooney, Aoife, Gaffney, Fiona, O'Connor, Laura, Leavy, Deirdre, O'Brien, Kate, Dowds, Joanne, Sugrue, Jamie A., Hopkins, David, Martin-Loeches, Ignacio, Ni Cheallaigh, Cliona, Nadarajan, Parthiban, McLaughlin, Anne Marie, Bourke, Nollaig M., Bergin, Colm, O'Farrelly, Cliona, Bannan, Ciaran, Conlon, Niall
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	United States Public Library of Science 09.11.2020 Public Library of Science (PLoS)
Témata:	Adult Aged Bacterial infections Betacoronavirus - isolation & purification Biochemistry Biology and life sciences C-reactive protein Chronic fatigue syndrome Clinical medicine Complications and side effects Coronavirus Infections - complications Coronavirus Infections - pathology Coronavirus Infections - virology Coronaviruses COVID-19 Cytokines Epidemics Fatigue Fatigue - epidemiology Fatigue - etiology Female Gerontology Hospitals Humans Illnesses Immune response Immune system Immunology Infections Infectious diseases Inflammation Interleukin 6 Interleukin-2 Receptor alpha Subunit - blood Interleukin-6 - blood L-Lactate dehydrogenase Lactate dehydrogenase Lactic acid Leukocytes Lymphocytes Male Markers Medicine Medicine and Health Sciences Middle Aged Outpatient care facilities Oxygen Pandemics Pneumonia, Viral - complications Pneumonia, Viral - pathology Pneumonia, Viral - virology Prevalence Risk factors SARS-CoV-2 Severe acute respiratory syndrome Severe acute respiratory syndrome coronavirus 2 Severity of Illness Index Supervision Townsend, Adam Viral diseases Ireland
ISSN:	1932-6203, 1932-6203
On-line přístup:	Získat plný text
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Abstract	Fatigue is a common symptom in those presenting with symptomatic COVID-19 infection. However, it is unknown if COVID-19 results in persistent fatigue in those recovered from acute infection. We examined the prevalence of fatigue in individuals recovered from the acute phase of COVID-19 illness using the Chalder Fatigue Score (CFQ-11). We further examined potential predictors of fatigue following COVID-19 infection, evaluating indicators of COVID-19 severity, markers of peripheral immune activation and circulating pro-inflammatory cytokines. Of 128 participants (49.5 ± 15 years; 54% female), more than half reported persistent fatigue (67/128; 52.3%) at median of 10 weeks after initial COVID-19 symptoms. There was no association between COVID-19 severity (need for inpatient admission, supplemental oxygen or critical care) and fatigue following COVID-19. Additionally, there was no association between routine laboratory markers of inflammation and cell turnover (leukocyte, neutrophil or lymphocyte counts, neutrophil-to-lymphocyte ratio, lactate dehydrogenase, C-reactive protein) or pro-inflammatory molecules (IL-6 or sCD25) and fatigue post COVID-19. Female gender and those with a pre-existing diagnosis of depression/anxiety were over-represented in those with fatigue. Our findings demonstrate a significant burden of post-viral fatigue in individuals with previous SARS-CoV-2 infection after the acute phase of COVID-19 illness. This study highlights the importance of assessing those recovering from COVID-19 for symptoms of severe fatigue, irrespective of severity of initial illness, and may identify a group worthy of further study and early intervention.
AbstractList	Fatigue is a common symptom in those presenting with symptomatic COVID-19 infection. However, it is unknown if COVID-19 results in persistent fatigue in those recovered from acute infection. We examined the prevalence of fatigue in individuals recovered from the acute phase of COVID-19 illness using the Chalder Fatigue Score (CFQ-11). We further examined potential predictors of fatigue following COVID-19 infection, evaluating indicators of COVID-19 severity, markers of peripheral immune activation and circulating pro-inflammatory cytokines. Of 128 participants (49.5 ± 15 years; 54% female), more than half reported persistent fatigue (67/128; 52.3%) at median of 10 weeks after initial COVID-19 symptoms. There was no association between COVID-19 severity (need for inpatient admission, supplemental oxygen or critical care) and fatigue following COVID-19. Additionally, there was no association between routine laboratory markers of inflammation and cell turnover (leukocyte, neutrophil or lymphocyte counts, neutrophil-to-lymphocyte ratio, lactate dehydrogenase, C-reactive protein) or pro-inflammatory molecules (IL-6 or sCD25) and fatigue post COVID-19. Female gender and those with a pre-existing diagnosis of depression/anxiety were over-represented in those with fatigue. Our findings demonstrate a significant burden of post-viral fatigue in individuals with previous SARS-CoV-2 infection after the acute phase of COVID-19 illness. This study highlights the importance of assessing those recovering from COVID-19 for symptoms of severe fatigue, irrespective of severity of initial illness, and may identify a group worthy of further study and early intervention.Fatigue is a common symptom in those presenting with symptomatic COVID-19 infection. However, it is unknown if COVID-19 results in persistent fatigue in those recovered from acute infection. We examined the prevalence of fatigue in individuals recovered from the acute phase of COVID-19 illness using the Chalder Fatigue Score (CFQ-11). We further examined potential predictors of fatigue following COVID-19 infection, evaluating indicators of COVID-19 severity, markers of peripheral immune activation and circulating pro-inflammatory cytokines. Of 128 participants (49.5 ± 15 years; 54% female), more than half reported persistent fatigue (67/128; 52.3%) at median of 10 weeks after initial COVID-19 symptoms. There was no association between COVID-19 severity (need for inpatient admission, supplemental oxygen or critical care) and fatigue following COVID-19. Additionally, there was no association between routine laboratory markers of inflammation and cell turnover (leukocyte, neutrophil or lymphocyte counts, neutrophil-to-lymphocyte ratio, lactate dehydrogenase, C-reactive protein) or pro-inflammatory molecules (IL-6 or sCD25) and fatigue post COVID-19. Female gender and those with a pre-existing diagnosis of depression/anxiety were over-represented in those with fatigue. Our findings demonstrate a significant burden of post-viral fatigue in individuals with previous SARS-CoV-2 infection after the acute phase of COVID-19 illness. This study highlights the importance of assessing those recovering from COVID-19 for symptoms of severe fatigue, irrespective of severity of initial illness, and may identify a group worthy of further study and early intervention. Fatigue is a common symptom in those presenting with symptomatic COVID-19 infection. However, it is unknown if COVID-19 results in persistent fatigue in those recovered from acute infection. We examined the prevalence of fatigue in individuals recovered from the acute phase of COVID-19 illness using the Chalder Fatigue Score (CFQ-11). We further examined potential predictors of fatigue following COVID-19 infection, evaluating indicators of COVID-19 severity, markers of peripheral immune activation and circulating pro-inflammatory cytokines. Of 128 participants (49.5 ± 15 years; 54% female), more than half reported persistent fatigue (67/128; 52.3%) at median of 10 weeks after initial COVID-19 symptoms. There was no association between COVID-19 severity (need for inpatient admission, supplemental oxygen or critical care) and fatigue following COVID-19. Additionally, there was no association between routine laboratory markers of inflammation and cell turnover (leukocyte, neutrophil or lymphocyte counts, neutrophil-to-lymphocyte ratio, lactate dehydrogenase, C-reactive protein) or pro-inflammatory molecules (IL-6 or sCD25) and fatigue post COVID-19. Female gender and those with a pre-existing diagnosis of depression/anxiety were over-represented in those with fatigue. Our findings demonstrate a significant burden of post-viral fatigue in individuals with previous SARS-CoV-2 infection after the acute phase of COVID-19 illness. This study highlights the importance of assessing those recovering from COVID-19 for symptoms of severe fatigue, irrespective of severity of initial illness, and may identify a group worthy of further study and early intervention.
Audience	Academic
Author	Conlon, Niall Martin-Loeches, Ignacio Dowds, Joanne Sugrue, Jamie A. Gaffney, Fiona McLaughlin, Anne Marie Bannan, Ciaran Bourke, Nollaig M. Ni Cheallaigh, Cliona Jones, Karen Leavy, Deirdre Townsend, Liam Hopkins, David O'Connor, Laura Dunne, Jean Mooney, Aoife Nadarajan, Parthiban Bergin, Colm O'Farrelly, Cliona Dyer, Adam H. O'Brien, Kate
AuthorAffiliation	3 Department of Immunology, St James’s Hospital, Dublin, Ireland 4 Department of Medical Gerontology, School of Medicine, Trinity Translational Medicine Institute, Trinity College Dublin, Dublin, Ireland 6 School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland 7 School of Medicine, Trinity College Dublin, Dublin, Ireland University of Sassari, ITALY 2 Department of Clinical Medicine, School of Medicine, Trinity Translational Medicine Institute, Trinity College Dublin, Dublin, Ireland 8 Department of Intensive Care Medicine, St James’s Hospital, Dublin, Ireland 5 Department of Physiotherapy, St James’s Hospital, Dublin, Ireland 1 Department of Infectious Diseases, St James’s Hospital, Dublin, Ireland 11 Department of Immunology, School of Medicine, Trinity College Dublin, Dublin, Ireland 9 Department of Respiratory Medicine, St James’s Hospital, Dublin, Ireland 10 Department of Comparative Immunology, School of Medicine, Trinity Colleg
AuthorAffiliation_xml	– name: University of Sassari, ITALY – name: 9 Department of Respiratory Medicine, St James’s Hospital, Dublin, Ireland – name: 11 Department of Immunology, School of Medicine, Trinity College Dublin, Dublin, Ireland – name: 7 School of Medicine, Trinity College Dublin, Dublin, Ireland – name: 10 Department of Comparative Immunology, School of Medicine, Trinity College Dublin, Dublin, Ireland – name: 5 Department of Physiotherapy, St James’s Hospital, Dublin, Ireland – name: 2 Department of Clinical Medicine, School of Medicine, Trinity Translational Medicine Institute, Trinity College Dublin, Dublin, Ireland – name: 6 School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland – name: 4 Department of Medical Gerontology, School of Medicine, Trinity Translational Medicine Institute, Trinity College Dublin, Dublin, Ireland – name: 1 Department of Infectious Diseases, St James’s Hospital, Dublin, Ireland – name: 8 Department of Intensive Care Medicine, St James’s Hospital, Dublin, Ireland – name: 3 Department of Immunology, St James’s Hospital, Dublin, Ireland
Author_xml	– sequence: 1 givenname: Liam orcidid: 0000-0002-7089-0665 surname: Townsend fullname: Townsend, Liam – sequence: 2 givenname: Adam H. orcidid: 0000-0003-1356-510X surname: Dyer fullname: Dyer, Adam H. – sequence: 3 givenname: Karen surname: Jones fullname: Jones, Karen – sequence: 4 givenname: Jean orcidid: 0000-0001-5816-3855 surname: Dunne fullname: Dunne, Jean – sequence: 5 givenname: Aoife surname: Mooney fullname: Mooney, Aoife – sequence: 6 givenname: Fiona surname: Gaffney fullname: Gaffney, Fiona – sequence: 7 givenname: Laura surname: O'Connor fullname: O'Connor, Laura – sequence: 8 givenname: Deirdre surname: Leavy fullname: Leavy, Deirdre – sequence: 9 givenname: Kate surname: O'Brien fullname: O'Brien, Kate – sequence: 10 givenname: Joanne surname: Dowds fullname: Dowds, Joanne – sequence: 11 givenname: Jamie A. surname: Sugrue fullname: Sugrue, Jamie A. – sequence: 12 givenname: David surname: Hopkins fullname: Hopkins, David – sequence: 13 givenname: Ignacio surname: Martin-Loeches fullname: Martin-Loeches, Ignacio – sequence: 14 givenname: Cliona surname: Ni Cheallaigh fullname: Ni Cheallaigh, Cliona – sequence: 15 givenname: Parthiban surname: Nadarajan fullname: Nadarajan, Parthiban – sequence: 16 givenname: Anne Marie surname: McLaughlin fullname: McLaughlin, Anne Marie – sequence: 17 givenname: Nollaig M. surname: Bourke fullname: Bourke, Nollaig M. – sequence: 18 givenname: Colm surname: Bergin fullname: Bergin, Colm – sequence: 19 givenname: Cliona surname: O'Farrelly fullname: O'Farrelly, Cliona – sequence: 20 givenname: Ciaran surname: Bannan fullname: Bannan, Ciaran – sequence: 21 givenname: Niall surname: Conlon fullname: Conlon, Niall
BackLink	https://www.ncbi.nlm.nih.gov/pubmed/33166287$$D View this record in MEDLINE/PubMed
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Copyright	COPYRIGHT 2020 Public Library of Science 2020 Townsend et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. 2020 Townsend et al 2020 Townsend et al
Copyright_xml	– notice: COPYRIGHT 2020 Public Library of Science – notice: 2020 Townsend et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. – notice: 2020 Townsend et al 2020 Townsend et al
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RelatedPersons	Townsend, Adam
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Snippet	Fatigue is a common symptom in those presenting with symptomatic COVID-19 infection. However, it is unknown if COVID-19 results in persistent fatigue in those...
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SubjectTerms	Adult Aged Bacterial infections Betacoronavirus - isolation & purification Biochemistry Biology and life sciences C-reactive protein Chronic fatigue syndrome Clinical medicine Complications and side effects Coronavirus Infections - complications Coronavirus Infections - pathology Coronavirus Infections - virology Coronaviruses COVID-19 Cytokines Epidemics Fatigue Fatigue - epidemiology Fatigue - etiology Female Gerontology Hospitals Humans Illnesses Immune response Immune system Immunology Infections Infectious diseases Inflammation Interleukin 6 Interleukin-2 Receptor alpha Subunit - blood Interleukin-6 - blood L-Lactate dehydrogenase Lactate dehydrogenase Lactic acid Leukocytes Lymphocytes Male Markers Medicine Medicine and Health Sciences Middle Aged Outpatient care facilities Oxygen Pandemics Pneumonia, Viral - complications Pneumonia, Viral - pathology Pneumonia, Viral - virology Prevalence Risk factors SARS-CoV-2 Severe acute respiratory syndrome Severe acute respiratory syndrome coronavirus 2 Severity of Illness Index Supervision Townsend, Adam Viral diseases
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Title	Persistent fatigue following SARS-CoV-2 infection is common and independent of severity of initial infection
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Volume	15
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