New Research Finds Lasting Fatigue Common After COVID-19 Infection


Fatigue is a frequently reported initial symptom among individuals infected with SARS-CoV-2.

Post-COVID fatigue is independent of severity of initial infection.

More than half of people with acute COVID-19 infection continue to have persistent fatigue 10 weeks after their initial illness, according to a new study published on November 9, 2020, in the open-access journal PLOS ONE by Liam Townsend of Trinity College Dublin, Ireland, and colleagues.

Fatigue is one of the most common initial presenting complaints of people infected with SARS-CoV-2, the virus that causes COVID-19. The long-term consequences of COVID-19 have not been well-studied and concern has been raised that the virus has the potential to trigger a post-viral fatigue syndrome.

In the new study, researchers tracked fatigue, as well as patient characteristics including COVID-19 severity, laboratory markers, levels of inflammatory markers, and pre-existing conditions, in 128 study participants who had previously been infected with SARS-CoV-2. The participants, all recruited from a post-COVID-19 outpatient clinic at St. James Hospital in Dublin, Ireland, were 54% female and averaged 49.5 years old (standard deviation ±15 years). 55.5% of the participants had been admitted to the hospital for their COVID-19 treatment while the remainder were treated as outpatients. On average, they were assessed for the study 72 days after discharge from a hospital or, if managed as an outpatient, after a timepoint 14 days following diagnosis.

Based on their score on the Chalder Fatigue Scale (CFQ-11), 52.3% (67/128) of study participants met the criteria for fatigue at the assessment point at least 6 weeks following COVID-19 infection. Only 42.2% of the patients (54/128) reported feeling back to their full health. Importantly, there was no association between COVID-19 severity, need for hospital admission, or routine laboratory markers of inflammation with the likelihood of experiencing persistent fatigue after infection. Though the study is limited in that the population cohort was predominantly white and Irish, and patients were only assessed at a single time point with no follow-up, the authors also found that female gender and a history of anxiety or depression was more common in the severe fatigue group (X2=9.95, p=0.002 for female; X2=5.18, p=0.02 for depression history).

The authors add: “This study highlights the burden of post-COVID fatigue. It also demonstrates that post-COVID fatigue is unrelated to the severity of initial infection, so predicting its development is not easy.”

Reference: “Persistent fatigue following SARS-CoV-2 infection is common and independent of severity of initial infection” by Liam Townsend, Adam H. Dyer, Karen Jones, Jean Dunne, Aoife Mooney, Fiona Gaffney, Laura O’Connor, Deirdre Leavy, Kate O’Brien, Joanne Dowds, Jamie A. Sugrue, David Hopkins, Ignacio Martin-Loeches, Cliona Ni Cheallaigh, Parthiban Nadarajan, Anne Marie McLaughlin, Nollaig M. Bourke, Colm Bergin, Cliona O’Farrelly, Ciaran Bannan and Niall Conlon, 9 November 2020, PLOS ONE.
DOI: 10.1371/journal.pone.0240784

Funding: LT has been awarded the Irish Clinical Academic Training (ICAT) Programme, supported by the Wellcome Trust and the Health Research Board (Grant Number 203930/B/16/Z), the Health Service Executive, National Doctors Training and Planning and the Health and Social Care, Research and Development Division, Northern Ireland. NC is part-funded by a Science Foundation Ireland (SFI) grant, Grant Code 20/SPP/3685. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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