Fatigue after COVID‐19 in non‐hospitalized patients according to sex

Abstract

Background Limited evidence exists on sex differences in post‐COVID fatigue among non‐hospitalized patients. Therefore, aim of the study was to evaluate the course of chronic fatigue symptoms in non‐hospitalized subjects with the SARS‐CoV‐2 infection, according to sex. Methods Patients and staff from the University Hospital in Krakow anonymously and retrospectively completed neuropsychological questionnaire that included eight symptoms of chronic fatigue syndrome. The presence of these symptoms was assessed before COVID‐19 and 0–4, 4–12, and >12 weeks postinfection. The inclusion criteria were as follows: age 18 or more years, >12 weeks since the onset of the SARS‐CoV‐2 infection, and diagnosis confirmed by the RT‐PCR from anasopharyngeal swab. Results We included 303 patients (79.53% women, 47.52% medical personnel) assessed retrospectively after a median of 30 (interquartile range: 23–35) weeks since the onset of symptoms. A higher prevalence of at least one chronic fatigue symptom was found in females in all time intervals after the onset of COVID‐19 compared to males (p < .036). Women, compared to men, more often experienced persistent fatigue, not caused by effort and persisting after rest (for <4 weeks, odds ratio [OR] = 2.31, 95% confidence interval [CI]: 1.13–4.73; for 4–12 weeks, OR = 1.95, 95% CI: 1.06–3.61), non‐restorative sleep (for <4 weeks, OR = 2.17, 95% CI: 1.23–3.81; for >12 weeks, OR = 1.95, 95% CI: 1.03–3.71), and sore throat (for <4 weeks, OR = 1.97, 95% CI: 1.03–3.78; for 4–12 weeks, OR = 2.76, 95% CI: 1.05–7.27). Sex differences in headache, arthralgia, and prolonged postexercise fatigue were observed only during the first 4 weeks (OR = 2.59, 95% CI: 1.45–4.60, OR = 2.97, 95% CI: 1.02–8.64, and OR = 1.87, 95% CI: 1.01–3.51, respectively). There were no differences between women and men in myalgia and self‐reported lymph node enlargement. Conclusions The course of post‐COVID fatigue differs significantly between sexes in non‐hospitalized individuals with COVID‐19, with women more often suffering from persistent fatigue, not caused by effort and persisting after rest, non‐restorative sleep, and sore throat.

Course of fatigue among patients previously hospitalised due to COVID-19

“…Nevertheless, most patients reported residual fatigue, which aligned with findings from previous studies [73]. Thirdly, the NP-COVID questionnaire was created for the purposes of this study; however, it was validated as described before [24]. Fourthly, our study focused on patients with wild-type or Alpha variant SARS-CoV-2; therefore, the presented results might not be applicable to other variants, especially given that individuals infected with Omicron have been shown to be less likely to exhibit long-COVID [74].…”

“…Post-COVID fatigue was assessed with the use of a question naire called "The NeuroPsychological Complications of COVID-19" (NP-COVID), created for the purposes of the current study and further validated, as described previously [24]. In brief, patients were retrospectively asked about the presence of the following symptoms: 1) persistent fatigue, not caused by effort, and persisting after rest, 2) sore throat, 3) self-reported lymph node enlargement, 4) myalgia, 5) arthralgia, 6) headache, 7) non-restorative sleep, and 8) prolonged post-exercise fatigue [24]. These symptoms were previously included in a definition of chronic fatigue syndrome (CFS) by the Centres for Disease Control and Prevention in 1994 [25] and, since then, they have been widely used even in newer definitions of the CFS [26].…”

“…We enrolled patients who fulfilled the following inclusion criteria that were also described previously [24]: age 18 or more years; more than three months since the onset of the SARS-CoV-2 infection; diagnosis of COVID-19 confirmed by detection of viral RNA by reverse transcription polymerase chain reaction (RT-PCR) from a nasopharyngeal swab; and ability to read and write. Additionally, for the purpose of the current study, we included only patients who had previously required hospitalisation due to SARS-CoV-2 infection.…”

“…The CRACoV-HHS project received approval of the Jagiellonian University Bioethics Committee. No additional approval from the Bioethics Committee was required since NP-COVID questionnaires were filled out anonymously [24]. Participants who were recruited in the post-COVID ambulatory in the University Hospital in Krakow signed written informed consent before the paper version of the NP-COVID questionnaire was handed to them.…”

Effect of Post-COVID-19 on Brain Volume and Glucose Metabolism: Influence of Time Since Infection and Fatigue Status

“…PCS is characterized as symptoms that last for at least two months after an acute COVID-19 illness and cannot be explained by an alternate diagnosis (WHO). Common symptoms include olfactory dysfunction (anosmia/parosmia/dysosmia), cognitive impairment, and, most commonly, fatigue [ 3 , 4 , 5 ]. Fatigue is a complex, multi-faceted phenomenon arising from various factors [ 5 ] and typically consists of feelings of tiredness and decreases in energy, motivation, and concentration, which can only be measured by self-reported questionnaires.…”