Long Haulers—What Is the Evidence for Post-COVID Fatigue?, 2021, Stengl et al

[Andy]

Introduction
Since the start of the pandemic until now (end of February 2021), more than 113 million people worldwide have been infected (encompassing people with and without symptoms) with SARS-CoV-2, with 89 million of those (78.8%) being classified as recovered (1). However, it became more and more apparent that people infected can have symptoms not only in the acute phase but also with a considerable delay. A recent meta-analysis from 15 studies encompassing 47,910 patients showed that 80% of patients develop at least one symptom during follow–up times ranging from 2 weeks to 4 months post viral infection (2). This condition is termed heterogeneously, namely, long COVID, post-COVID, or recently post-acute sequelae of SARS-CoV2 (PASC). The most common symptoms were fatigue (58%), headache (44%), attention disorder (27%), hair loss (25%), and dyspnea (24%) (Table 1) (2). The long-term outcome of these symptoms remains to be investigated. The current opinion article will discuss the current state of knowledge on the development of long COVID symptoms with a special focus on post-COVID fatigue being the most common symptom.

...

In summary, a SARS-CoV-2-infection might trigger post-COVID fatigue as a variant of long COVID. Whether this is specific for SARS-CoV-2 or rather a broader risk factor for the development of a functional disease/bodily distress disorder as observed before for, e.g., post-infectious IBS, will have to be further investigated. Moreover, more emphasis should be given to the characterization of risk factors for the development of functional post-COVID symptoms so patients at higher risk can be given higher attention in a personalized approach, screened early, and provided early help to avoid over-diagnosing and iatrogenic somatic fixation. Hereby, the close collaboration of internal medicine practitioners and those specialized in psychosomatic medicine/psychiatry is key to offer treatment in an integrated manner. It is likely that treatments encouraging active participation of patients (e.g., exercise or psychotherapy) might be more effective than passive options (e.g., medication alone) as described for other functional disorders before (14).

Open access, https://www.frontiersin.org/articles/10.3389/fpsyt.2021.677934/full

 

[Peter T]

‘There is evidence that Long Covid’ exists so let’s just apply all the things we made up about other related symptom sets without any meaningful evidence base to that as well’.

 

[Simon M]

iatrogenic

Iatrogenic is a great word. It refers to harm caused by medical examination or treatment, which seems very appropriate to the BPS approach.

 

[DokaGirl]

From the article:

"Interestingly, the majority of these patients described above also reported other symptoms. Two thirds (69%) also complained about fatigue; another 13 and 12% patients showed signs of anxiety and depression, respectively (3). However, another publication showed that fatigue developed irrespective of a preceding hospitalization and was therefore not associated with the severity of the initial SARS-CoV-2 disease (6). Moreover, female sex (7) and previous episodes of depression or anxiety were observed more often in patients developing fatigue (6), which contrasts with the risk factors for the development of the vascular long COVID symptoms. A perceived high level of perceived social stigmatization due to the infection status was associated with an increased risk of developing impaired general mental health post SARS-CoV-2 infection, while a high level of social support showed the opposite association (8)."(my bolding)


In my experience, one doesn't need to be hospitalized with a severe disease to have fatigue for a while after. Milder flu can do that. The kind that doesn't send you to hospital. EBV can do that. Probably there are others. The theory of people overblowing the severity of the situation (hysteria) is being used here to point to Long Haul COVID as a psychosomatic condition.

As well, this article contains the time worn theory that it's mostly women, and by BPS definition, hysterical persons, that have post COVID fatigue. It appears the MeToo Movement has not seen the light of day within the BPS Movement.



From the article:

"Moreover, more emphasis should be given to the characterization of risk factors for the development of functional post-COVID symptoms so patients at higher risk can be given higher attention in a personalized approach, screened early, and provided early help to avoid over-diagnosing and iatrogenic somatic fixation." (my bolding)

Round up and select out the so-called more likely candidates who may already be "hysterical", or just waiting to become so. Scrutinize them, and then effectively ban them from further medical investigations.

 

[Arnie Pye]

@DokaGirl

Excellent post - but depressing in view of all the time-worn stereotypes being trundled out yet again.

 

[rvallee]

In summary, a SARS-CoV-2-infection might trigger post-COVID fatigue as a variant of long COVID. Whether this is specific for SARS-CoV-2 or rather a broader risk factor for the development of a functional disease/bodily distress disorder as observed before for, e.g., post-infectious IBS, will have to be further investigated. Moreover, more emphasis should be given to the characterization of risk factors for the development of functional post-COVID symptoms so patients at higher risk can be given higher attention in a personalized approach, screened early, and provided early help to avoid over-diagnosing and iatrogenic somatic fixation. Hereby, the close collaboration of internal medicine practitioners and those specialized in psychosomatic medicine/psychiatry is key to offer treatment in an integrated manner. It is likely that treatments encouraging active participation of patients (e.g., exercise or psychotherapy) might be more effective than passive options (e.g., medication alone) as described for other functional disorders before (14).

This is more dripping in moral judgment than the average religious sermon. These people are clearly not capable of handling the responsibilities of medicine, they do not take their job seriously.