The DOI matches its Crossref record; 76 of the 78 references it cites were found in a registry or an index.
Persistent fatigue following SARS-CoV-2 infection is common and independent of severity of initial infection
Open accessPublished version of a preprint
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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“Literature data are not equivocal about the association between females and long COVID: some preliminary studies have shown an increased prevalence of fatigue [24] or other symptoms among women [1,5,13,16], while in other studies no gender association was found [4,[18], [19], [20]].”
From Female gender is associated with long COVID syndrome: a prospective cohort study (2022) · cites this paper as [24]
In the citing paper
“Fatigue (58%) is the most common symptom of long and acute COVID-1923.”
From More than 50 long-term effects of COVID-19: a systematic review and meta-analysis (2021) · cites this paper as [23]
In the citing paper
“It is present even after 100 days of the first symptom of acute COVID-194,23.”
From More than 50 long-term effects of COVID-19: a systematic review and meta-analysis (2021) · cites this paper as [23]
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Cites
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More than 50 long-term effects of COVID-19: a systematic review and meta-analysis
Lopez-Leon, S., Wegman-Ostrosky, T., Perelman, C., Sepulveda, R., Rebolledo, P. A., Cuapio, A., & Villapol, S. (2021) · Scientific Reports · doi:10.1038/s41598-021-95565-8 · Cited by 2,757
Long COVID or post-COVID-19 syndrome: putative pathophysiology, risk factors, and treatments
Yong, S. J. (2021) · Infectious Diseases · doi:10.1080/23744235.2021.1924397 · Cited by 1,339
Long covid—mechanisms, risk factors, and management
Crook, H., Raza, S., Nowell, J., Young, M., & Edison, P. (2021) · BMJ · doi:10.1136/bmj.n1648 · Cited by 1,655
Yeoh, Y. K., Zuo, T., Lui, G. C.-Y., Zhang, F., Liu, Q., Li, A. Y. L., Chung, A. C., Cheung, C. P., Tso, E. Y. K., Fung, K. S., et al. (2021) · Gut · doi:10.1136/gutjnl-2020-323020 · Cited by 1,346
Phetsouphanh, C., Darley, D. R., Wilson, D. B., Howe, A., Munier, C. M. L., Patel, S. K., Juno, J. A., Burrell, L. M., Kent, S. J., Dore, G. J., et al. (2022) · Nature Immunology · doi:10.1038/s41590-021-01113-x · Cited by 1,062
Metadata
- 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
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2020-11-09
- Volume
- 15
- Issue
- 11
- Pages
- e0240784
- ISSN
- 1932-6203 (ISSN-L)
- 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
- 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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