Estimates of Incidence and Predictors of Fatiguing Illness after SARS-CoV-2 Infection

Abstract

This study aimed to estimate the incidence rates of post-COVID-19 fatigue and chronic fatigue and to quantify the additional incident fatigue caused by COVID-19. We analyzed electronic health records data of 4,589 patients with confirmed COVID-19 during February 2020-February 2021 who were followed for a median of 11.4 (interquartile range 7.8-15.5) months and compared them to data from 9,022 propensity score-matched non-COVID-19 controls. Among COVID-19 patients (15% hospitalized for acute COVID-19), the incidence rate of fatigue was 10.2/100 person-years and the rate of chronic fatigue was 1.8/100 person-years. Compared with non-COVID-19 controls, the hazard ratios were 1.68 (95% CI 1.48-1.92) for fatigue and 4.32 (95% CI 2.90-6.43) for chronic fatigue. The observed association between COVID-19 and the significant increase in the incidence of fatigue and chronic fatigue reinforces the need for public health actions to prevent SARS-CoV-2 infections.

Keywords: COVID-19; ME/CFS; PASC; PCC; SARS-CoV-2; coronavirus disease 2019; fatigue; incidence; myalgic encephalomyelitis/chronic fatigue syndrome; post COVID-19 conditions; post-acute sequelae of SARS-CoV-2 infection; respiratory infections; severe acute respiratory syndrome coronavirus 2; viruses; zoonoses.

Figure 1

Data flow for COVID-19 cases in study of incidence and predictors of fatiguing illness after SARS-CoV-2 infection, Washington, USA, February 2020–February 2021.

Figure 2

Cumulative incidence of fatigue (A) and chronic fatigue (B) among 4,589 COVID-19 cases and 9,022 non–COVID-19 controls in study of fatiguing illness after SARS-CoV-2 infection, Washington, USA, February 2020–February 2021. Shading around data lines indicates 95% CIs.

Figure 3

Clinical outcomes among COVID-19 patients with and without incident fatigue after SARS-CoV-2 infection in study of fatiguing illness after SARS-CoV-2 infection, Washington, USA, February 2020–February 2021.