Exercise responses in those with vs. without persistent fatigue post-COVID-19

Persistent fatigue is a common, debilitating, and poorly understood symptom post-COVID-19. Fatigue post-COVID19 is not associated with disease severity, and therefore not limited to those recovered from severe infection. Using cardiopulmonary exercise testing (CPET), we sought to characterize differences between those with vs. without postCOVID-19 fatigue. 49 individuals were included 3-months post-discharge if hospitalized with COVID-19 or 3-months after their last positive SARS-CoV-2 test. Participants were grouped based on the presence of any persistent fatigue relative to the acute phase of infection (fatigue, n=34) or lack thereof (non-fatigue, n=15). An incremental CPET on a cycle ergometer was performed to symptom limitation. Participants also completed self-administered questionnaires, pulmonary function testing, and a resting echocardiogram. While dyspnoea intensity ratings were elevated in the fatigue group throughout exercise (p=0.04), relative peak oxygen consumption was the only significant betweengroup difference in physiological responses (19.9+/-7.1 fatigue vs. 24.4+/-6.7 ml/kg/min non-fatigue, p=0.04). Anxiety, depression, and distress were higher in those with fatigue vs. without, despite similar resting pulmonary and cardiac function as well as COVID-19 disease severity. Our findings suggest that cardiorespiratory fitness and/or psychological factors may contribute to post-COVID-19 fatigue. It is also possible that a higher psychological burden intensifies symptom perception such as dyspnoea during exercise in those with vs. without fatigue or that fatigue leads to secondary psychological symptoms.

Who Should Get Vaccinated First? Limits of Solidarity during the First Week of the Danish Vaccination Programme

The coronavirus disease 2019 (COVID-19) pandemic resulted in several acute shortages of healthcare provision and thereby posed a challenge to solidarity among citizens of welfare states. One example was the limited number of vaccine batches at the outset of European COVID-19 vaccination campaigns. This resulted in a rare constellation in which citizens faced both a unifying collective threat but also a scarcity of healthcare resources that necessitated the prioritization of certain groups for an early vaccination. On that premise, we conducted a survey experiment during the first week of the Danish vaccination programme. Our results demonstrate that citizens judged who deserves early access to preventive healthcare along established lines of welfare chauvinism. Fictitious diabetes patients with a Muslim name and those who recently immigrated were regarded as less deserving of an early vaccination. That said, concerns over responsibility for one's hardship and anti-social free-rider behaviour drive citizens considerations, too. Contra our hypotheses, we find only weak evidence that immigrants or Muslims are penalized more harshly for an irresponsible lifestyle or free-rider behaviour. Compared with previous research, we study a unique moment in history and are the first to disentangle minority status from stereotypes about their anti-social free-riding behaviour and irresponsibly unhealthy lifestyles.