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Post-COVID-19 fatigue: A systematic review
Open accessAbstract
Fatigue is recognized as one of the most commonly presented long-term complaints in individuals previously infected with SARS-CoV-2. This systematic review was performed to describe symptoms, etiology, possible risk factors related to post-COVID-19 fatigue and the therapeutic approaches used for the treatment of post-COVID-19 fatigue. For the systematic literature search the databases PubMed, Web of Science, Cochrane Library, and PsycInfo were used. All articles that met the inclusion criteria were analyzed for demographics, clinical data and treatment. Included were studies which focused on an adult population (18–65 years old); elderly patients and patients with chronic somatic diseases which can also cause fatigue were excluded. We identified 2,851, screened 2,193 and finally included 20 studies with moderate to high methodological quality, encompassing 5,629 participants. Potential risk factors for post-COVID-19 fatigue were old age, female sex, severe clinical status in the acute phase of infection, a high number of comorbidities, and a prediagnosis of depression/anxiety. Lastly, a possible autoimmune etiology was suspected. Several treatment approaches have been tested mostly in small and uncontrolled studies so far: a Chinese herbal formulation improved breathlessness and fatigue. Moreover, molecular hydrogen (H2) inhalation had beneficial health effects in terms of improved physical (6-min walking test) and respiratory function in patients with post-COVID-19. Patients also noticed improvement in fatigue after undergoing hyperbaric oxygen therapy (HBOT) and enhanced external counterpulsation (EECP). Lastly. muscle strength and physical function were improved after undergoing an 8-weeks biweekly physical therapy course including aerobic training, strengthening exercises, diaphragmatic breathing techniques, and mindfulness training. However, larger and controlled studies e.g., investigating the effect of physical and / or psychotherapy for patients with post-COVID-19 fatigue are urgently warranted. Systematic Review Registration Unique Identifier: CRD42022320676, https://www.crd.york.ac.uk/PROSPERO/ .
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“Second, specific symptom-based interventions are usually provided (Chennapragada et al., 2022), which makes it difficult to address comorbid EDs, for instance, anxiety and depressive symptoms that are simultaneously present in COVID-19 patients (Joli et al., 2022).”
From Unified Protocol for the transdiagnostic treatment of emotional disorders in people with post COVID-19 condition: study protocol for a multiple baseline n-of-1 trial (2023) · cites this paper as Joli et al., 2022
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Metadata
- Authors
- Joli, J., Buck, P., Zipfel, S., & Stengel, A.
- Affiliations
- Universitätsklinikum Tübingen (DE)
- Humboldt-Universität zu Berlin (DE)
- Corresponding author
- Stengel, Andreas
- Venue
- Frontiers in Psychiatry
- Publisher
- Frontiers Media SA
- Published
- 2022-08-11
- Volume
- 13
- Pages
- 947973-947973
- ISSN
- 1664-0640 (ISSN-L)
- PMC
- PMC9403611
- OpenAlex
- W4291015998
- Cited by
- 155
- References
- 59
- Citations by year
- 2026: 20 · 2025: 32 · 2024: 50 · 2023: 48 · 2022: 5
- FWCI
- 4.87
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Psychiatry (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Deutsche Forschungsgemeinschaft
- 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, long COVID, COVID-19 pandemic, risk factors, autoimmune etiology, Chinese herbal medicine, hyperbaric oxygen therapy, enhanced external counterpulsation, physiotherapy, aerobic exercise, mindfulness training, diaphragmatic breathing, anxiety and depression, comorbidities
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