Multidimensional Characterization of Long COVID Fatigue, 2025, Maas et al.

[SNT Gatchaman]

Multidimensional Characterization of Long COVID Fatigue
Matthew B. Maas; Kathryn J Reid; Millenia Jimenez; Melissa Lopez; Janet Miller; Mercedes R Carnethon; Phyllis C Zee; Kristen L Knutson; Igor J Koralnik

OBJECTIVES
We performed a multidimensional analysis of mood, cognition, sleep and circadian rhythms in patients with post-acute sequelae of SARS-CoV-2 infection (PASC) with the objective of characterizing the phenotype of PASC fatigue.

METHODS
We recruited adult patients from a Neuro-COVID-19 Clinic with persistence of disabling symptoms beyond 6 weeks from acute infection. Self-reported symptoms were assessed with Patient-Reported Outcomes Measurement Information System instruments. We evaluated cognitive performance using NIH Toolbox measures and assessed sleep and rest-activity rhythms by 7 days of wrist actigraphy. We performed level 2 polysomnography in a subset of 20 participants.

RESULTS
We studied 58 participants: 83% White, 59% female and 91% not hospitalized for COVID-19. Fatigue severity was significantly correlated with worse self-reported cognitive abilities but not with objectively measured cognitive performance and with greater depression symptoms, several rest-activity rhythm and light exposure disruption measures, and greater actigraphy measured sleep time and time in bed. A multivariable model found significant, independent associations between fatigue severity and subjective cognitive abilities, depression symptoms, and rest-activity rhythm disruption.

CONCLUSIONS
Long total sleep times, disruption of light exposure and circadian rest-activity patterns, depression and subjective cognitive impairment are associated with PASC fatigue. Behaviorally influenced sleep and circadian abnormalities may exacerbate fatigue and be targets for therapeutic interventions.

Link (Behavioral Sleep Medicine) [Paywall]

 

[Trish]

Yet again the unwarranted step from association to causation to treatment.

 

[Peter T]

More work for ‘the sleep police’, even though we have no idea of what causes what, or what action if any might help.

With my ME/CFS sleep disturbance my anecdotal response is that trying to police my sleep makes me more tired and the best answer is to just do what my body tells me to do. This may or may not be sensible, but no one has any evidence that seeking to impose a supposedly normal sleep pattern has any benefit in ME/CFS or in Long Covid.

 

[Trish]

There seems to be a strong belief among clinicians that what is good for keeping people healthy when they are well must therefore be good, and even curative, for sick people. Hence rehabilitation not convalescence. Hence - exercise, sleep hygiene, healthy diet, going to work... are all pushed as cures. It's cruel.

 

[Peter T]

There seems to be a strong belief among clinicians that what is good for keeping people healthy when they are well must therefore be good, and even curative, for sick people. Hence rehabilitation not convalescence. Hence - exercise, sleep hygiene, healthy diet, going to work... are all pushed as cures. It's cruel.

Even though current sleeping patterns (ie in Western industrial societies) are a cultural as much as a biological phenomenon. The problem is potentially the clinicians’ need for conformity rather than anything to do with individual patients’ needs.