Correlates of fatigue in SARS-CoV-2-positive and -negative adolescents and young adults: Repeated cross-sectional analyses from a prospective cohort study
PURPOSE
To investigate cross-sectional associations between concurrent fatigue and a range of covariates in adolescents and young adults with acute SARS-CoV-2 infection and follow-up six months after infection, as well as in SARS-CoV-2-negative controls.
METHODS
A total of 404 SARS-CoV-2 -positive adolescents and young adults were studied during their infection and again six months post-infection, compared to 105 SARS-CoV-2-negative controls. In this exploratory study, cross-sectional linear regression analyses were conducted at each time point to examine associations between fatigue and a range of covariates, including biomarkers, functional tests, symptoms, and psychological traits.
RESULTS
Fatigue was significantly and strongly associated with all other symptoms (p < 0.001), poor sleep quality (p < 0.001), psychological traits and negative emotions (p < 0.001), and lower quality of life (p < 0.001), across all cohorts. During the early convalescent phase of SARS-CoV-2 infection, fatigue showed few cross-sectional associations with immunological or autonomic markers, whereas such associations were observed six months after infection. COVID-negative controls also displayed immunological associations with fatigue.
CONCLUSIONS
Fatigue was consistently linked to concurrent symptom burden, insufficient sleep, negative emotions, and reduced quality of life, irrespective of infection status or timing. The lack of immunological and autonomic associations with fatigue during the early convalescent phase of SARS-CoV-2 infection are followed by their presence at six months. Findings suggests that the pattern of correlates may differ over time. These exploratory cross-sectional findings are non-causal and cannot establish directionality but are compatible with neuroscientific models on persistent symptoms and sustained arousal.
HIGHLIGHTS
• Fatigue is strongly tied to symptom burden, sleep, mood, and life quality.
• Symptom–fatigue associations are similar in acute COVID, post-COVID, and controls.
• Acute COVID fatigue shows minimal immunologic or autonomic associations.
• Immune and autonomic correlates emerge only with prolonged post-COVID fatigue.
Web | DOI | Journal of Psychosomatic Research | Open Access
Brodwall; Selvakumar; Havdal; Sommen; Berven; Cvejic; Wyller; Pedersen
PURPOSE
To investigate cross-sectional associations between concurrent fatigue and a range of covariates in adolescents and young adults with acute SARS-CoV-2 infection and follow-up six months after infection, as well as in SARS-CoV-2-negative controls.
METHODS
A total of 404 SARS-CoV-2 -positive adolescents and young adults were studied during their infection and again six months post-infection, compared to 105 SARS-CoV-2-negative controls. In this exploratory study, cross-sectional linear regression analyses were conducted at each time point to examine associations between fatigue and a range of covariates, including biomarkers, functional tests, symptoms, and psychological traits.
RESULTS
Fatigue was significantly and strongly associated with all other symptoms (p < 0.001), poor sleep quality (p < 0.001), psychological traits and negative emotions (p < 0.001), and lower quality of life (p < 0.001), across all cohorts. During the early convalescent phase of SARS-CoV-2 infection, fatigue showed few cross-sectional associations with immunological or autonomic markers, whereas such associations were observed six months after infection. COVID-negative controls also displayed immunological associations with fatigue.
CONCLUSIONS
Fatigue was consistently linked to concurrent symptom burden, insufficient sleep, negative emotions, and reduced quality of life, irrespective of infection status or timing. The lack of immunological and autonomic associations with fatigue during the early convalescent phase of SARS-CoV-2 infection are followed by their presence at six months. Findings suggests that the pattern of correlates may differ over time. These exploratory cross-sectional findings are non-causal and cannot establish directionality but are compatible with neuroscientific models on persistent symptoms and sustained arousal.
HIGHLIGHTS
• Fatigue is strongly tied to symptom burden, sleep, mood, and life quality.
• Symptom–fatigue associations are similar in acute COVID, post-COVID, and controls.
• Acute COVID fatigue shows minimal immunologic or autonomic associations.
• Immune and autonomic correlates emerge only with prolonged post-COVID fatigue.
Web | DOI | Journal of Psychosomatic Research | Open Access