Severe Fatigue in Long COVID: Web-Based Quantitative Follow-up Study in Members of Online Long COVID Support Groups.
Severe Fatigue in Long COVID: Web-Based Quantitative Follow-up Study in Members of Online Long COVID Support Groups.
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DOI：
10.2196/30274
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发表时间：
2021-09-21
影响因子：
7.4
通讯作者：
Spruit MA
中科院分区：
文献类型：
--
作者：
Van Herck M;Goërtz YMJ;Houben-Wilke S;Machado FVC;Meys R;Delbressine JM;Vaes AW;Burtin C;Posthuma R;Franssen FME;Hajian B;Vijlbrief H;Spies Y;van 't Hul AJ;Janssen DJA;Spruit MA
疲劳是COVID-19（即长COVID）后持续主诉的患者最常见的症状。对疲劳强度和区分身心疲劳的纵向研究缺乏。本研究的目的是(1)评估在线长期COVID同伴支持小组成员的疲劳程度，以及(2)评估这些小组的成员是否经历过精神疲劳、身体疲劳或两者兼而有之。在出现感染症状约3个月和6个月后确诊的在线长期COVID同伴支持小组成员中进行了一项基于网络的两波随访研究。人口统计学、COVID-19诊断、接受医疗保健（来自医疗专业人员或联合医疗专业人员）、疲劳（检查表个人力量-主观疲劳量表[cis -疲劳]，8-56分）和身心疲劳（自编问题，3-21分）进行评估。分数越高表明疲劳程度越严重。CIS-Fatigue评分≥36分为重度疲劳。共有239例聚合酶链反应/计算机断层扫描确诊的COVID-19患者分别在感染症状出现后10周（SD 2）和23周（SD 2） （T1和T2）完成调查。239例患者中，198例（82.8%）为女性；142人（59.4%）没有自我报告的既往共病；208人（87%）在感染COVID-19之前自我报告健康状况良好；急性感染住院62例（25.9%）。中位年龄为50岁（IQR 39-56）。绝大多数患者在T1和T2时出现严重疲劳（n=204, 85.4%, n=188, 78.7%）。在T1和T2之间，正常、轻度和重度疲劳的患病率无显著差异（P= 0.12）。T1时CIS-Fatigue评分中位数为48分（IQR 42-53）， T1至T2时CIS-Fatigue评分中位数下降（中位数变化为-2分，IQR -7至3分，P< 0.001）。T1时，身体疲劳评分中位数为19分（IQR 16-20），精神疲劳评分中位数为15分（IQR 10-17）；T2时身体疲劳得分较低，而精神疲劳得分较低（身体疲劳变化中位数为-1分，IQR为-3至0分，P< 0.001；精神疲劳变化中位数为0分，IQR为-3至3分，P= 0.52）。在完成随访调查时，194/239（81.2%）和164/239（68.6%）的患者分别接受了至少一名医疗专业人员和一名联合卫生保健专业人员的护理。确诊COVID-19的在线COVID-19长期支持小组成员的疲劳在症状出现后10至23周内减少。尽管如此，严重疲劳仍然非常普遍。身体和精神都很疲劳。目前还不清楚疲劳是否以及在多大程度上能在长期内自行消退。荷兰试验登记册NTR8705；https://www.trialregister.nl/trial/8705。
Fatigue is the most commonly reported symptom in patients with persistent complaints following COVID-19 (ie, long COVID). Longitudinal studies examining the intensity of fatigue and differentiating between physical and mental fatigue are lacking. The objectives of this study were to (1) assess the severity of fatigue over time in members of online long COVID peer support groups, and (2) assess whether members of these groups experienced mental fatigue, physical fatigue, or both. A 2-wave web-based follow-up study was conducted in members of online long COVID peer support groups with a confirmed diagnosis approximately 3 and 6 months after the onset of infectious symptoms. Demographics, COVID-19 diagnosis, received health care (from medical professionals or allied health care professionals), fatigue (Checklist Individual Strength–subscale subjective fatigue [CIS-Fatigue]; 8-56 points), and physical and mental fatigue (self-constructed questions; 3-21 points) were assessed. Higher scores indicated more severe fatigue. A CIS-Fatigue score ≥36 points was used to qualify patients as having severe fatigue. A total of 239 patients with polymerase chain reaction/computed tomography–confirmed COVID-19 completed the survey 10 weeks (SD 2) and 23 weeks (SD 2) after onset of infectious symptoms, respectively (T1 and T2). Of these 239 patients, 198 (82.8%) were women; 142 (59.4%) had no self-reported pre-existing comorbidities; 208 (87%) self-reported being in good health before contracting COVID-19; and 62 (25.9%) were hospitalized during acute infection. The median age was 50 years (IQR 39-56). The vast majority of patients had severe fatigue at T1 and T2 (n=204, 85.4%, and n=188, 78.7%, respectively). No significant differences were found in the prevalence of normal, mild, and severe fatigue between T1 and T2 (P=.12). The median CIS-Fatigue score was 48 points (IQR 42-53) at T1, and it decreased from T1 to T2 (median change: –2 points, IQR –7 to 3; P<.001). At T1, a median physical fatigue score of 19 points (IQR 16-20) and a median mental fatigue score of 15 points (IQR 10-17) were reported; these scores were lower at T2 for physical but not for mental fatigue (median change for physical fatigue –1 point, IQR –3 to 0, P<.001; median change for mental fatigue 0 points, IQR –3 to 3, P=.52). At the time of completing the follow-up survey, 194/239 (81.2%) and 164/239 (68.6%) of all patients had received care from at least one medical professional and one allied health care professional, respectively. Fatigue in members of online long COVID support groups with a confirmed COVID-19 diagnosis decreases from 10 to 23 weeks after onset of symptoms. Despite this, severe fatigue remains highly prevalent. Both physical and mental fatigue are present. It remains unclear whether and to what extent fatigue will resolve spontaneously in the longer term. Netherlands Trial Register NTR8705; https://www.trialregister.nl/trial/8705.
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