ABSTRACT
Background: Reports of long-lasting symptoms after covid-19 have raised serious concerns. Specifically, fatigue seems to be a predominant symptom after hospitalization with Covid-19. Aims and objectives: To investigate the burden of fatigue after hospitalization with Covid-19. Method(s): Patients hospitalized with PCR-proven Covid-19 in Central Denmark Region were invited for follow-up 3-6 months after discharge. Assessment included self-reported symptoms, Fatigue Assessment Score (FAS), and pulmonary function test (PFT) with registration of percent predicted forced expiratory volume in one second (FEV1%) and diffusion capacity (DLCO%). Basic characteristics from hospitalization were registered. Result(s): Among 218 patients (median age 59.9, 59% males) median FAS score was 24.0 (IQR 18.0-32.0). Patients were subdivided into three categories based on disease severity;Group A: Patients without oxygen (n=57), Group B: Patients requiring oxygen therapy at the ward (n=120) and Group C: patients admitted at ICU (n=41). Group A had a median length of hospital stay of 1.0 day (IQR 0.0-2.0), which was significantly shorter than Group B (5 days, p<0.05) and Group C (23 days, p<0.05). Fatigue was most common in group A: 52% reported mild-to-moderate fatigue and 25% reported severe fatigue. In contrast, severe fatigue was reported by 16% in Group B and 14% in Group C. Median FEV1% was 106.0% (94.0-112.0), DLCO% 89.5% (IQR 77.5-98.0) in Group A. Median DLCO% was significantly lower in Group B (83.0%, p<0.05) and in Group C (70.0%, p<0.05). Conclusion(s): Significant fatigue is frequent after hospitalization with Covid-19 and associated to short length of hospital stay and normal lung function tests.
ABSTRACT
Background: SARS-CoV-2 virus, causing Covid-19, continues to be a public health concern. Long-term sequela after infection with Covid-19 has been reported worldwide and holds the risk of becoming a major health concern. Ongoing symptoms more than 3 months after infection is now defined as long Covid. Fatigue and psychological distress are among the most common symptoms in long Covid. Aim: To investigate severe fatigue and psychological distress after hospitalization in patients with Covid-19. Methods: Patients hospitalized with Covid-19 in the Central Denmark Region were invited for follow-up 3- 6 months after discharge. Psychological distress was measured by Hospital Anxiety and Depression Scale (HADS) with a HADS score ≥8 identifying cases of anxiety and depression in the two subdomains. Fatigue was assessed using Fatigue Assessment Scale (FAS) with a FAS ≥35 indicating severe fatigue. Basic characteristics from the hospitalization were registered. Results: A total of 218 patients (mean age 59.9 (95% CI 58.2, 61.7), 59% men) reported a mean HADS of 7.9 (95% CI 6.95, 8.93). Cases of anxiety and depression were found in 23 and 16% of all patients, respectively. Overall, a mean FAS of 25.6 (95% CI 24.3, 26.9) was found with 34 patients (18%) reporting severe fatigue. Patients with severe fatigue (mean age of 54.2 (95% CI 50.3, 58.1), 47% males), cases of anxiety and depression was reported by 59 and 62%, respectively. Analyses of FAS in subdomains on mental and physical fatigue showed mean scores of 19.3 (95% CI 18.5, 20.2) and 20.6 (95% CI 19.8, 21.5), respectively. Conclusion: Severe fatigue is common after hospitalization in patients with Covid-19 and includes both mental and physical fatigue. In addition, cases of anxiety and depression are common in patients with severe fatigue.
ABSTRACT
OBJECTIVE: To investigate the peripheral nerve and muscle function electrophysiologically in patients with persistent neuromuscular symptoms following Coronavirus disease 2019 (COVID-19). METHODS: Twenty consecutive patients from a Long-term COVID-19 Clinic referred to electrophysiological examination with the suspicion of mono- or polyneuropathy were included. Examinations were performed from 77 to 255 (median: 216) days after acute COVID-19. None of the patients had received treatment at the intensive care unit. Of these, 10 patients were not even hospitalized. Conventional nerve conduction studies (NCS) and quantitative electromyography (qEMG) findings from three muscles were compared with 20 age- and sex-matched healthy controls. RESULTS: qEMG showed myopathic changes in one or more muscles in 11 patients (55%). Motor unit potential duration was shorter in patients compared to healthy controls in biceps brachii (10.02 ± 0.28 vs 11.75 ± 0.21), vastus medialis (10.86 ± 0.37 vs 12.52 ± 0.19) and anterior tibial (11.76 ± 0.31 vs 13.26 ± 0.21) muscles. All patients with myopathic qEMG reported about physical fatigue and 8 patients about myalgia while 3 patients without myopathic changes complained about physical fatigue. CONCLUSIONS: Long-term COVID-19 does not cause large fibre neuropathy, but myopathic changes are seen. SIGNIFICANCE: Myopathy may be an important cause of physical fatigue in long-term COVID-19 even in non-hospitalized patients.