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Severe, Persistent, Disruptive Fatigue Post-SARS-CoV-2 Disproportionately Affects Young Women, 2023, Price et al.

Discussion in 'Long Covid research' started by SNT Gatchaman, Oct 5, 2023.

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  1. SNT Gatchaman

    SNT Gatchaman Senior Member (Voting Rights)

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    Severe, Persistent, Disruptive Fatigue Post-SARS-CoV-2 Disproportionately Affects Young Women
    Jillian Kallman Price; Leyla de Avila; Maria Stepanova; Ali A Weinstein; Huong Pham; Wisna’odom Keo; Andrei Racila; Suzannah Gerber; Brian P Lam; Lynn H Gerber; Zobair M Younossi

    Introduction: Post-acute SARS-CoV-2 (PASC) symptoms are often persistent, disruptive, and difficult to treat effectively. Fatigue is often among the most frequently reported symptoms and may indicate a more challenging road to recovery.

    Purpose: To describe the natural history, symptomology, and risk profile of long-term post-acute SARS-CoV-2.

    Patients and Methods: Participants treated for SARS-CoV-2 within a large, community health system in the US were enrolled prospectively in a longitudinal, observational PASC study examining participants at enrollment and 6 months. Medical history, symptom reporting, validated measures of cognition, and patient-reported outcomes (PROs), were performed for all participants and repeated during study follow-up visits.

    Results: A total of 323 participants completed baseline evaluations. Sixty one participants indicated clinically significant fatigue (23.1% at baseline); a representative sample of 141 enrollees also completed a baseline Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) in-depth fatigue reporting questionnaire, 37 had severe fatigue. The severely fatigued (FACIT-F ≤29.7) were significantly younger, female, had more anxiety and depression, had a higher resting heart rate, reported more sick days, and were less physically active post-COVID. They were more likely to have a diagnosis of chronic kidney disease (13.5% vs 2.9%) but less likely to have a history of cancer (8.1% vs 23.1). Participants who were severely fatigued reported health, diet, weight, and sleep were worse than those not severely fatigued post-COVID (p = 0.02 to 0.0002). Fatigue was significantly correlated with impairment of all PROs administered after COVID-19 infection.

    Conclusion: Fatigue is a common symptom post-COVID-19 infection and is associated with lower reported well-being and function. Those with severe fatigue tended to be younger and female and have a past medical history of anxiety, depression, kidney disease, and more sedentary lifestyles.

    Link | PDF (International Journal of General Medicine)
     
    SNT Gatchaman, Oct 5, 2023
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    Hutan likes this.
  2. SNT Gatchaman

    SNT Gatchaman Senior Member (Voting Rights)

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    No new information, just another study counting symptoms and noting there's a problem.

    Does include a new variation on messing up ME/CFS —

     
    SNT Gatchaman, Oct 5, 2023
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    Wyva, EndME, Sean and 3 others like this.
  3. Hutan

    Hutan Moderator Staff Member

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    The introduction sets up the findings (note, no references given for the idea that food and beverage, exercise etc choices etc affect PASC risk):

    The participants had to be treated for Covid-19 by the health system - there's a bias there to people who were either more significantly affected or perhaps more anxious (for a range of reasons) about having the infection. They don't tell us how many of the people they treated agreed to be part of the study. There surely had to be some self-selection bias operating there.
    It isn't clear to me when 'baseline' is, apart from it's when the person was enrolled. It seems to be well after the acute illness as 41% of people at baseline had no symptoms.

    This was at baseline:
    I'm not to sure what the denominator is in those percentages for symptoms (is it a percentage of the whole sample, or just of the 58% reporting persistent symptoms?). But regardless, with only 20.5% reporting fatigue and with 7.6% reporting a rash for example, these people are very variable in symptom presentation. It means it is very hard to draw any conclusions from this that might be relevant to ME/CFS.

    And things get more complicated after the baseline with people dropping out of followups.



    There is not enough evidence here to think that this statement applies to post-Covid ME/CFS. There are many reasons why people with lower preCovid exercise behaviours and/or who were severely affected by the infection might have lingering symptoms including fatigue that they attribute to the infection.




    In case it's not obvious, I'm less than impressed with this paper. It just adds more confusion to the existing confusion. The authors pat themselves on the back for their understanding of fatigue and yet the concept of PEM is not mentioned anywhere. And, having suggested that it's young women with high levels of anxiety and depression who don't exercise and don't eat well who are at risk, they then note the low representation of adults in the "18-20s age range" in their sample. I assume "20s" means 20 to 29. (edit - why would you present an age range as 18-20s rather than 18-29 other than to minimise the impact of the poor representation on the conclusion - a conclusion that even gets presented in the title?)

     
    Last edited: Oct 5, 2023
    Hutan, Oct 5, 2023
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    alktipping, EndME, SNT Gatchaman and 1 other person like this.

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