Covid-19 Associated Extreme Fatigue Effects on Activities of Daily Living in Mild and Long-Haul Infections: Patient Perspectives from a Remote Patient Monitoring Program

ABSTRACT

Objective: Here, we report the impact of COVID-19 associated extreme fatigue on activities of daily living from the patient perspective in both mild and long haul COVID-19 patients. This narrative emphasis will offer opportunities for the development of neurological protocols and interventions for the treatment and support of affected individuals. Background: Extreme fatigue has been shown to be a neurological effect of COVID-19 infection. It is critical to better understand the impact this symptom has on daily functioning across the spectrum of morbidity associated with COVID-19 infection. Patient perspective on extreme fatigue affords deeper insight into illness experience, clinical course of COVID-19 associated fatigue, and opportunities for neurological and social intervention. Design/Methods: 46 Patients in a COVID-19 Remote Patient Monitoring Program (Precision Recovery Mount Sinai Health System) were interviewed regarding their experience with COVID-19. Patients were asked about their experiences navigating COVID-19 diagnoses, the health care system, and their recovery process. References to fatigue were analyzed for statistical and qualitative significance. Results: 34/46 patients (74%) reported extreme fatigue as a symptom of their COVID-19 infection. 16/34 patients (47%) were self-reported long haul COVID-19 patients, which represented 16/18 (89%) of the long haul patients in the study. Patients reported three categories of impact on activities of daily living (1) care for self;(2) care for others;and (3) employment responsibilities and continuation. The critical secondary effects of this fatigue included (1) barrier to healthcare;(2) social isolation;(3) malnutrition;(4) necessity of outside caretakers for children;and (5) employment termination. Conclusions: COVID-19 extreme fatigue had debilitating effects on activities of daily living for both mild and long-haul patients. This is critical to acknowledge, not only for development of protocol and interventional treatment, but also for the development of social support for impacted individuals, including food access, child care, and employment response.