The Interactive Effects of Post-Traumatic Stress Symptoms and Breathlessness on Fatigue Severity in Post-COVID-19 Syndrome 2022 Harenwall et al

Abstract

Background: Post-traumatic stress symptoms (PTSS) and breathlessness have been well documented in the acute phase of COVID-19 as well as in Post-COVID-19 Syndrome (PCS), commonly known as Long-COVID. The present study aimed to explore whether PTSS and breathlessness interact to exacerbate fatigue among individuals recovering from PCS, similar to the effects evidenced in other health conditions that feature respiratory distress..

Methods: Outcome measures were collected from 154 participants reporting persistent fatigue following acute COVID-19 infection who were enrolled in a 7-week rehabilitation course provided by the Primary Care Wellbeing Service (PCWBS) in Bradford District Care NHS Foundation Trust (BDCFT).

Results: Hierarchical multiple linear regression revealed that fatigue severity was associated with a significant interaction between PTSS and breathlessness, even when controlling for pre-COVID health related quality of life (HRQoL), age, symptom duration and hospital admittance during the acute phase. Furthermore, improvements in fatigue following rehabilitation were significantly associated with improvements in PTSS.

Conclusions: PTSS may be an important therapeutic target in multidisciplinary rehabilitation for reducing fatigue in the recovery from PCS. It is therefore important that treatment for PCS takes a biopsychosocial approach to recovery, putting emphasis on direct and indirect psychological factors which may facilitate or disrupt physical recovery. This highlights the need for all PCS clinics to screen for PTSD and if present, target as a priority in treatment to maximise the potential for successful rehabilitation.

Open access, https://www.mdpi.com/2077-0383/11/20/6214/htm

 

"Previous research has suggested a relationship between Post-Traumatic Stress Disorder (PTSD) and fatigue, specifically ME/CFS [10] and fatigue in population-based samples [11]. According to DSM-5 criteria, PTSD includes witnessing a traumatic event, persistently re-experiencing that event (intrusive memories, nightmares), avoiding thoughts and feelings about the trauma, and changes in negative mood and arousal which cause significant distress and functional impairment. Importantly, PTSD can arises following exposure to traumatic events perceived to represent a threat to life, including life-threatening illnesses [12] such as COVID-19. Whilst the exact underlying mechanisms are unknown, the hypothalamo–pituitary–adrenal (HPA) axis plays a major role in regulating stress responses [13,14]. Likewise, changes in the HPA axis are hallmarks of PTSD [15], ME/CFS [16] and post-viral fatigue [17]. It is likely that, similarly to ME/CFS, fatigue in PCS may be exacerbated by PTSD. Indeed, evidence is now emerging to suggest that PTSD is consistently identified in those with living with PCS [18]. Likewise, previous epidemics have shown an increased risk of PTSD among survivors following recovery from both SARS and MERS [19,20]. PTSD may be higher among those who experienced severe illness due to COVID-19, especially those admitted to an intensive care unit (ICU) or hospitalised with severe illness [21]. However, PTSD has also been widely reported in the general population due the psychosocial impact of social isolation, uncertainty of disease progression, financial losses, increased perception of risk, etc. [22]."

 

What is the acute phase post- of? Post-starting to be sick but still acutely sick? Good grief at least respect the linear passage of time, or something. This is ridiculous to the point of being propaganda.

And since the "symptoms" labeled as traumatic stress are common symptoms of not just COVID but illness in general, this is self-referential evidence. All this is is labeling symptoms with one preferred attribution. Means nothing at all. Means as much as labeling symptoms as functional/conversion, or spiritual, or lacking in life energy, or whatever. Nothing but a giant false attribution error.

 

So close, yet so far. I have ME and PTSD. Having flashbacks when your body is frail, trying to regulate extreme emotions when you're cognitively impaired, or having nightmares when a good night's sleep is barely restful, is freaking exhausting. But they're painting with too broad a brush. Treating your PTSD won't cure your illness and breathing exercises aren't going to un-trash your lungs. People need to realize that BPS treatments, at their very best, are coping strategies, but in general, a net negative, because that labor and money could have gone towards biomedical research.

I want to see 100% of ME and LC funding put towards biomedical research, because we already know how to self-manage. There's only one thing we all want, only one thing we can think about, and that's a cure.