Post-COVID-19 fatigue: the contribution of cognitive and neuropsychiatric symptoms, 2022, Calabria et al

Abstract

Fatigue in its many forms of physical, mental, and psychosocial exhaustion is a common symptom of post-COVID-19 condition, also known as “Long COVID.” Persistent fatigue in COVID-19 patients is frequently accompanied by cognitive dysfunction and neuropsychiatric symptoms; however, less is known about the relationships between these components of post-COVID-19 condition and fatigue itself. Consequently, the present study sought to (1) distinguish the types of fatigue experienced by participants, and (2) investigate whether cognitive deficits across various domains and neuropsychiatric conditions predicted these different types of fatigue.

The study included 136 COVID-19 patients referred for neuropsychological evaluation due to cognitive complaints 8 months on average after SARS-CoV-2 infection. Measures included self-reported fatigue (physical, cognitive, and psychosocial), neuropsychiatric questionnaires (assessing symptoms of depression, anxiety, apathy, and executive functioning), a comprehensive neuropsychological assessment, and self-reported quality of life and everyday functioning.

Results showed that reports of clinical significant fatigue were pervasive in our sample (82.3% of participants), with physical fatigue rated highest on average relative to the subscale maximum. Elevated levels of apathy, anxiety, and executive dysfunction in neuropsychiatric measures along with executive and attentional difficulties on cognitive tests were found to be consistently important predictors among different types of fatigue.

This implicates both cognitive and neuropsychiatric symptoms as predictors of fatigue in post-COVID-19 condition, and stresses the importance of a holistic approach in assessing and considering potential treatment for COVID-19 patients experiencing fatigue.

Open access, https://link.springer.com/article/10.1007/s00415-022-11141-8

 

Are the researchers not aware of the concept of co-morbidity?

It does? OK. I guess it's because of the way it is. I mean if someone says it, it must be true?

It really self-defeats the purpose to advise to think "holistically", then try to, somehow, isolate symptoms from its context. This thinking of "a primary symptom of" is really just about the opposite of thinking of the whole problem, it literally makes a part of the whole as if it is the whole.

Makes exactly as much sense as generally thinking specifics.

 

A predictor is an association, not a proven causal factor. It could easily be that cognitive energy or fatigue dysfunction is driving any supposed symptoms, or that there is a common underlying factor they are not looking at and may not have been discovered yet. It may also be that they are misinterpreting symptoms or making dubious classifications.

Arguing for a need for an holistic approach is bogus in clinical practice until there is hard evidence. It could be used to "justify" a multidisciplinary research study, but not clinical practice, at least not from an evidence based nor scientific perspective.

I really hope they will be using objective measures, as the unblinded subjective studies using psychiatric methods have been a total fail in methodology. I also hope that if they have no beneficial objective outcome they will move on from LC research. I hope but I do not expect - the history of these types of claims says otherwise.