Severe, Persistent, Disruptive Fatigue Post-SARS-CoV-2 Disproportionately Affects Young Women

Abstract

Jillian Kallman Price,1 Leyla de Avila,1 Maria Stepanova,1– 3 Ali A Weinstein,4 Huong Pham,1 Wisna’odom Keo,1 Andrei Racila,1 Suzannah Gerber,1 Brian P Lam,1– 3 Lynn H Gerber,1,3,* Zobair M Younossi1– 3,* 1Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, USA; 2Center for Liver Disease, Department of Medicine, Inova Fairfax Medical Campus, Falls Church, VA, USA; 3Inova Medicine, Inova Health System, Falls Church, VA, USA; 4Department of Global and Community Health, George Mason University, Fairfax, VA, USA*These authors contributed equally to this workCorrespondence: Jillian Kallman Price, Research Investigator, Outcomes Research, Beatty Liver and Obesity Research Program, Center for Integrated, Research, Department of Medicine, Inova Health System, Claude Moore Health Education and Research Building, Inova Fairfax Medical Campus, 3300, Gallows Road, Falls Church, VA, 22042, USA, Tel [phone], Fax [phone], Email [email protected]: Post-acute SARS-CoV-2 (PASC) symptoms are often persistent, disruptive, and difficult to treat effectively. Fatigue is often among the most frequently reported symptoms and may indicate a more challenging road to recovery.Purpose: To describe the natural history, symptomology, and risk profile of long-term post-acute SARS-CoV-2.Patients and Methods: Participants treated for SARS-CoV-2 within a large, community health system in the US were enrolled prospectively in a longitudinal, observational PASC study examining participants at enrollment and 6 months. Medical history, symptom reporting, validated measures of cognition, and patient-reported outcomes (PROs), were performed for all participants and repeated during study follow-up visits.Results: A total of 323 participants completed baseline evaluations. Sixty one participants indicated clinically significant fatigue (23.1% at baseline); a representative sample of 141 enrollees also completed a baseline Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) in-depth fatigue reporting questionnaire, 37 had severe fatigue. The severely fatigued (FACIT-F ≤ 29.7) were significantly younger, female, had more anxiety and depression, had a higher resting heart rate, reported more sick days, and were less physically active post-COVID. They were more likely to have a diagnosis of chronic kidney disease (13.5% vs 2.9%) but less likely to have a history of cancer (8.1% vs 23.1). Participants who were severely fatigued reported health, diet, weight, and sleep were worse than those not severely fatigued post-COVID (p = 0.02 to 0.0002). Fatigue was significantly correlated with impairment of all PROs administered after COVID-19 infection.Conclusion: Fatigue is a common symptom post-COVID-19 infection and is associated with lower reported well-being and function. Those with severe fatigue tended to be younger and female and have a past medical history of anxiety, depression, kidney disease, and more sedentary lifestyles.Keywords: symptom severity, functional assessment of chronic illness therapy-fatigue, FACIT-F, SARS-CoV-2, COVID-19, recovery

Keywords

• symptom severity
• functional assessment of chronic illness therapy-fatigue
• facit-f
• sars-cov-2
• covid-19
• recovery