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. 2022 Jun;50(3):661-669.
doi: 10.1007/s15010-021-01733-3. Epub 2022 Jan 7.

Comparison of fatigue, cognitive dysfunction and psychological disorders in post-COVID patients and patients after sepsis: is there a specific constellation?

Andreas Stallmach #  1   2 , Miriam Kesselmeier #  3   4 , Michael Bauer  3   5 , Judith Gramlich  6 , Kathrin Finke  7 , Anne Fischer  6 , Carolin Fleischmann-Struzek  3   8 , Astrid Heutelbeck  9 , Katrin Katzer  6 , Stephanie Mutschke  6 , Mathias W Pletz  8 , Stefanie Quickert  6 , Konrad Reinhart  3   10 , Zoe Stallmach  6 , Martin Walter  11 , André Scherag #  3   4 , Philipp A Reuken #  6
Affiliations

Comparison of fatigue, cognitive dysfunction and psychological disorders in post-COVID patients and patients after sepsis: is there a specific constellation?

Andreas Stallmach et al. Infection. 2022 Jun.

Abstract

Background: Sequelae of COVID-19 can be severe and longlasting. We compared frequencies of fatigue, depression and cognitive dysfunction in survivors of SARS-CoV-2-infection and sepsis.

Methods: We performed a prospective cohort study of 355 symptomatic post-COVID patients who visited our out-patient clinic for post-COVID-19 care. We compared them with 272 symptomatic patients from the Mid-German Sepsis Cohort, which investigates the long-term courses of sepsis survivors. Possible predictors for frequent clinical findings (fatigue, signs of depression, cognitive dysfunction) in post-COVID were investigated with multivariable logistic regression.

Results: Median age of the post-COVID patients was 51 years (range 17-86), 60.0% were female, and 31.8% required hospitalization during acute COVID-19. In the post-COVID patients (median follow-up time: 163 days) and the post-sepsis patients (180 days), fatigue was found in 93.2% and 67.8%, signs of depression were found in 81.3% and 10.9%, and cognitive dysfunction was found in 23.5% and 21.3%, respectively. In post-COVID, we did not observe an association between fatigue or depression and the severity of acute COVID-19. In contrast, cognitive dysfunction was associated with hospitalization (out-patient versus in-patient) and more frequent in post-COVID patients treated on an ICU compared to the MSC patients.

Conclusion: In post-COVID patients, fatigue and signs of depression are more common than in sepsis survivors, independent from the acute SARS-CoV-2-infection. In contrast, cognitive dysfunction is associated with hospitalization. Despite the differences in frequencies, owing to the similarity of post-COVID and post-sepsis sequelae, this knowledge may help in implementing follow-up approaches after SARS-CoV-2 infection.

Keywords: COVID-19; Long-COVID; Post-COVID; SARS-CoV2; Sepsis.

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Conflict of interest statement

All authors report no conflict of interest regarding the content of the manuscript.

Figures

Fig. 1
Fig. 1
Relative frequencies (grey bar) of psychiatric and cognitive diagnostic findings of patients suffering from the post-COVID-syndrome (stratified by kind of hospital stay) and patients after intensive cared sepsis or septic shock (MSC, Mid-German Sepsis Cohort). Additionally, 95% confidence intervals (black, vertical segments) are given. Percentage refers to patients who provided information for the respective finding (number provided below the bars). In addition, p values from comparing post-COVID patients with MSC patients are provided above the bars. All post-COVID patients as well as the subgroup of post-COVID patients with ICU stay are compared with post-sepsis patients (all with ICU stay). Of note, all patients with information on the respective finding are included in the comparison of all post-COVID patients with the MSC patients, although four post-COVID patients with fatigue, three with depression and three with cognitive dysfunction could not be included in the bars due to missing information on their hospital stay. Data are related to the time point 5–6 months after the disease. ICU intensive care unit
See this image and copyright information in PMC

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