The Prevalence, Severity, and Impact of Post-COVID Persistent Fatigue, Post-Exertional Malaise, and Chronic Fatigue Syndrome 2022 Nehme et al

[Andy]

BACKGROUND

Fatigue is common after viral infections, including SARS-CoV-2.1 Our purpose was to report the prevalence and impact of persistent fatigue 6 months after SARS-CoV-2 infection, considering post-exertional malaise2 and criteria for chronic fatigue syndrome.3

METHODS
Since March 2020, individuals tested for SARS-CoV-2 at the Geneva University Hospitals outpatient testing center benefit from remote ambulatory follow-up (COVICARE).1 This study included all individuals tested between March 2020 and December 2020 and whose follow-up was at 6 months or more after their test date.

Follow-up included questions about the prevalence of symptoms (yes/no) and their severity using a Likert scale (mild, moderate, or severe). Fatigue was assessed using the Eastern Cooperative Oncology Group (ECOG) scale and the Chalder fatigue scale.4 The Chalder fatigue scale was scored using the 4-item Likert and the bimodal scoring schemes. A score of ≥ 4 on bimodal scoring indicated severe fatigue. The DePaul brief questionnaire5 was used to identify post-exertional malaise and criteria for chronic fatigue syndrome. The Sheehan Disability Scale was used to assess functional impairment. Reduced work capacity was defined as missing days off work or having a reduced productivity on the Sheehan disability scale. Comorbidities were considered present if pre-existing prior to SARS-CoV-2 infection. Statistical analysis included descriptive comparisons of percentages using chi-square tests and Student’s t test.

RESULTS
Overall, 5515 individuals participated in this study (response rate 70.7%), with 5406 participants at 6 months or more after their test date. A total of 1497 (27.7%) participants had a documented positive SARS-CoV-2 test and were ultimately included in the study. The median time for follow-up was 225 days (interquartile range 207–398). Respectively, fatigue was reported by 17.2%, post-exertional malaise by 8.2%, and the presence of criteria for chronic fatigue syndrome by 1.1% of SARS-CoV-2-positive individuals, compared to 8.9%, 3.5%, and 0.5% of SARS-CoV-2-negative individuals.

Open access, https://link.springer.com/article/10.1007/s11606-022-07882-x

 

[Andy]

"The DePaul brief questionnaire evaluated the frequency and severity of symptoms characterizing post-exertional malaise including heaviness or drowsiness after exercise, pain, fatigue, and exhaustion after minimal effort, as well as the time required for recovery. Using a Likert scale, a score of 2 or more on the frequency (5 questions) and severity (5 questions) of symptoms indicated post-exertional malaise. If recovery required more than 14 h after minimal physical or mental activity, the questionnaire was positive for chronic fatigue syndrome."

 

[cassava7]

The DePaul PEM questionnaire has its flaws but it is interesting to see that, overall, twice as many test-positive participants met the IOM criteria (1.1% vs 0.5%) considering that the incidence of CFS up to two years after the swine flu pandemic was doubled in non-vaccinated vs vaccinated Norwegians.