Cited by 911Long-Term Effects of COVID-19COVID-19 Clinical Research StudiesCOVID-19 and Mental Health

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Persistent fatigue following SARS-CoV-2 infection is common and independent of severity of initial infection

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Townsend, Liam, Dyer, Adam H., Jones, Karen, Dunne, Jean, Mooney, Aoife, Gaffney, Fiona, O'Connor, Laura, Leavy, Deirdre, O'Brien, Kate, Dowds, Joanne, Sugrue, Jamie A., Hopkins, David, Martin-Loeches, Ignacio, Ni Cheallaigh, Cliona, Nadarajan, Parthiban, McLaughlin, Anne Marie, Bourke, Nollaig M., Bergin, Colm, O'Farrelly, Cliona, Bannan, Ciaran, Conlon, Niall·2020·PLOS ONE

DOI 10.1371/journal.pone.0240784PMC PMC7652254

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Abstract

Fatigue is a common symptom in those presenting with symptomatic COVID-19 infection. However, it is unknown if COVID-19 results in persistent fatigue in those recovered from acute infection. We examined the prevalence of fatigue in individuals recovered from the acute phase of COVID-19 illness using the Chalder Fatigue Score (CFQ-11). We further examined potential predictors of fatigue following COVID-19 infection, evaluating indicators of COVID-19 severity, markers of peripheral immune activation and circulating pro-inflammatory cytokines. Of 128 participants (49.5 ± 15 years; 54% female), more than half reported persistent fatigue (67/128; 52.3%) at median of 10 weeks after initial COVID-19 symptoms. There was no association between COVID-19 severity (need for inpatient admission, supplemental oxygen or critical care) and fatigue following COVID-19. Additionally, there was no association between routine laboratory markers of inflammation and cell turnover (leukocyte, neutrophil or lymphocyte counts, neutrophil-to-lymphocyte ratio, lactate dehydrogenase, C-reactive protein) or pro-inflammatory molecules (IL-6 or sCD25) and fatigue post COVID-19. Female gender and those with a pre-existing diagnosis of depression/anxiety were over-represented in those with fatigue. Our findings demonstrate a significant burden of post-viral fatigue in individuals with previous SARS-CoV-2 infection after the acute phase of COVID-19 illness. This study highlights the importance of assessing those recovering from COVID-19 for symptoms of severe fatigue, irrespective of severity of initial illness, and may identify a group worthy of further study and early intervention.

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Authors: Townsend, L., Dyer, A. H., Jones, K., Dunne, J., Mooney, A., Gaffney, F., O'Connor, L., Leavy, D., O'Brien, K., Dowds, J., Sugrue, J. A., Hopkins, D., Martin-Loeches, I., Ni Cheallaigh, C., Nadarajan, P., McLaughlin, A. M., Bourke, N. M., Bergin, C., O'Farrelly, C., Bannan, C., & Conlon, N.
Affiliations: Trinity College Dublin (IE)
St. James's Hospital (IE)
Corresponding author: Townsend, Liam
ORCID: Townsend, Liam
Dyer, Adam H.
Jones, Karen
Dunne, Jean
Mooney, Aoife
Leavy, Deirdre
Sugrue, Jamie A.
Nadarajan, Parthiban
McLaughlin, Anne Marie
Bourke, Nollaig M.
Bergin, Colm
Conlon, Niall
Venue: PLOS ONE
Publisher: Public Library of Science (PLoS)
Published: 2020-11-09
Volume: 15
Issue: 11
Pages: e0240784
ISSN: 1932-6203 (ISSN-L)
DOI: 10.1371/journal.pone.0240784
PMC: PMC7652254
OpenAlex: W3102327145
Cited by: 911
References: 78
Citations by year: 2026: 25 · 2025: 69 · 2024: 124 · 2023: 190 · 2022: 242 · 2021: 244 · 2020: 14
FWCI: 74.27
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
creativecommons.org/licenses/by/4.0/ (vor)
Locations: PLoS ONE (publishedVersion, cc-by)
medRxiv (acceptedVersion, cc-by-nc-nd)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders: Wellcome Trust (203930/B/16/Z)
Health Research Board (203930/B/16/Z)
Topics: Health Sciences › Medicine › Clinical Neurology › Long-Term Effects of COVID-19
Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
Keywords: post-COVID-19 fatigue, persistent fatigue, COVID-19 pandemic, post-viral fatigue, Chalder Fatigue Questionnaire, COVID-19 severity, inflammatory cytokines, interleukin-6, soluble interleukin-2 receptor, peripheral immune activation, depression, anxiety, sex differences, C-reactive protein, lactate dehydrogenase
MeSH terms: Betacoronavirus, COVID-19, SARS-CoV-2, Adult, Aged, Fatigue, Female, Humans, Male, Middle Aged, Pneumonia, Viral, Severity of Illness Index, Interleukin-6, Prevalence, Coronavirus Infections, Interleukin-2 Receptor alpha Subunit, Pandemics

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Persistent fatigue following SARS-CoV-2 infection is common and independent of severity of initial infection

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