Prevalence and Determinants of Fatigue after COVID-19 in Non-Hospitalized Subjects: A Population-Based Study

• Published in: International journal of environmental research and public health Vol. 18; no. 4; p. 2030
• Main Authors: Stavem, Knut, Ghanima, Waleed, Olsen, Magnus K., Gilboe, Hanne M., Einvik, Gunnar
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 19.02.2021; MDPI
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Comorbidity; Coronaviruses; COVID-19; COVID-19 - complications; Dyspnea; Fatigue; Fatigue - epidemiology; Female; Hospitalization; Hospitals; Humans; Laboratories; Male; Middle Aged; Population; Population-based studies; Prevalence; Questionnaires; Regression analysis; Respiratory diseases; Severe acute respiratory syndrome coronavirus 2; Surveys and Questionnaires; Survivors; Variables; Womens health; Young Adult; Norway; COVID-19; prevalence; post-infectious fatigue; fatigue; CFQ-11
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph18042030

This study assessed the prevalence and determinants of fatigue in a population-based cohort of non-hospitalized subjects 1.5–6 months after COVID-19. It was a mixed postal/web survey of all non-hospitalized patients ≥18 years with a positive PCR for SARS-CoV-2 until 1 June 2020 in a geographically defined area. In total, 938 subjects received a questionnaire including the Chalder fatigue scale (CFQ-11) and the energy/fatigue scale of the RAND-36 questionnaire. We estimated z scores for comparison with general population norms. Determinants were analyzed using multivariable logistic and linear regression analysis. In total, 458 subjects (49%) responded to the survey at median 117.5 days after COVID-19 onset, and 46% reported fatigue. The mean z scores of the CFQ-11 total was 0.70 (95% CI 0.58 to 0.82), CFQ-11 physical 0.66 (0.55 to 0.78), CFQ-11 mental 0.47 (0.35 to 0.59) and RAND-36 energy/fatigue −0.20 (−0.31 to −0.1); all CFQ-11 scores differed from those of the norm population (p < 0.001). Female sex, single/divorced/widowed, short time since symptom debut, high symptom load, and confusion during acute COVID-19 were associated with higher multivariable odds of fatigue. In conclusion, the burden of post-viral fatigue following COVID-19 was high, and higher than in a general norm population. Symptoms of fatigue were most prevalent among women, those having a high symptom load, or confusion during the acute phase.