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Risk Factors and Multidimensional Assessment of Long Coronavirus Disease Fatigue: A Nested Case-Control Study.
Margalit, Ili; Yelin, Dana; Sagi, Moshe; Rahat, Maya Merav; Sheena, Liron; Mizrahi, Nadav; Gordin, Yael; Agmon, Hadar; Epstein, Nitzan Karny; Atamna, Alaa; Tishler, Ori; Daitch, Vered; Babich, Tanya; Abecasis, Donna; Yarom, Yoni; Kazum, Shirit; Shitenberg, Dorit; Baltaxe, Erik; Elkana, Odelia; Shapira-Lichter, Irit; Leibovici, Leonard; Yahav, Dafna.
  • Margalit I; Infectious Diseases Unit, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel.
  • Yelin D; COVID Recovery Clinic, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel.
  • Sagi M; Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel.
  • Rahat MM; COVID Recovery Clinic, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel.
  • Sheena L; Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel.
  • Mizrahi N; Department of Internal Medicine F, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel.
  • Gordin Y; Department of Internal Medicine E, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel.
  • Agmon H; Department of Internal Medicine F, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel.
  • Epstein NK; Department of Internal Medicine B, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel.
  • Atamna A; The Hebrew University-Hadassah Medical School, Hebrew University, Jerusalem, Israel.
  • Tishler O; Department of Internal Medicine B, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel.
  • Daitch V; Department of Internal Medicine B, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel.
  • Babich T; Infectious Diseases Unit, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel.
  • Abecasis D; COVID Recovery Clinic, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel.
  • Yarom Y; Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel.
  • Kazum S; COVID Recovery Clinic, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel.
  • Shitenberg D; Department of Internal Medicine F, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel.
  • Baltaxe E; Department of Internal Medicine E, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel.
  • Elkana O; Research Authority, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel.
  • Shapira-Lichter I; Functional MRI Center, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel.
  • Leibovici L; Medix Sport Medicine Center, Tel Aviv, Israel.
  • Yahav D; Department of Cardiology, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel.
Clin Infect Dis ; 75(10): 1688-1697, 2022 Nov 14.
Article in English | MEDLINE | ID: covidwho-2117296
ABSTRACT

BACKGROUND:

Fatigue is the most prevalent and debilitating long-COVID (coronavirus disease) symptom; however, risk factors and pathophysiology of this condition remain unknown. We assessed risk factors for long-COVID fatigue and explored its possible pathophysiology.

METHODS:

This was a nested case-control study in a COVID recovery clinic. Individuals with (cases) and without (controls) significant fatigue were included. We performed a multidimensional assessment evaluating various parameters, including pulmonary function tests and cardiopulmonary exercise testing, and implemented multivariable logistic regression to assess risk factors for significant long-COVID fatigue.

RESULTS:

A total of 141 individuals were included. The mean age was 47 (SD 13) years; 115 (82%) were recovering from mild coronavirus disease 2019 (COVID-19). Mean time for evaluation was 8 months following COVID-19. Sixty-six (47%) individuals were classified with significant long-COVID fatigue. They had a significantly higher number of children, lower proportion of hypothyroidism, higher proportion of sore throat during acute illness, higher proportions of long-COVID symptoms, and of physical limitation in daily activities. Individuals with long-COVID fatigue also had poorer sleep quality and higher degree of depression. They had significantly lower heart rate [153.52 (22.64) vs 163.52 (18.53); P = .038] and oxygen consumption per kilogram [27.69 (7.52) vs 30.71 (7.52); P = .036] at peak exercise. The 2 independent risk factors for fatigue identified in multivariable analysis were peak exercise heart rate (OR .79 per 10 beats/minute; 95% CI .65-.96; P = .019) and long-COVID memory impairment (OR 3.76; 95% CI 1.57-9.01; P = .003).

CONCLUSIONS:

Long-COVID fatigue may be related to autonomic dysfunction, impaired cognition, and decreased mood. This may suggest a limbic-vagal pathophysiology. CLINICAL TRIALS REGISTRATION NCT04851561.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Fatigue / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Adult / Humans / Middle aged Language: English Journal: Clin Infect Dis Journal subject: Communicable Diseases Year: 2022 Document Type: Article Affiliation country: Cid

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Fatigue / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Adult / Humans / Middle aged Language: English Journal: Clin Infect Dis Journal subject: Communicable Diseases Year: 2022 Document Type: Article Affiliation country: Cid