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. 2024 Sep 1;56(9):1563-1573.
doi: 10.1249/MSS.0000000000003455. Epub 2024 Apr 14.

Factors Associated with Fatigue in COVID-19 ICU Survivors

Djahid Kennouche  1 , Clément Foschia  2 , Callum G Brownstein  1 , Thomas Lapole  1 , Diana Rimaud  1 , Nicolas Royer  1 , Franck LE Mat  1 , Guillaume Thiery  3 , Vincent Gauthier  4 , Pascal Giraux  5 , Lydia Oujamaa  6 , Marine Sorg  2 , Samuel Verges  7 , Stéphane Doutreleau  7 , Mathieu Marillier  7 , Mélanie Prudent  8 , Laurent Bitker  9 , Léonard Féasson  1 , Laurent Gergelé  10 , Emeric Stauffer  8 , Céline Guichon  11 , Julien Gondin  12 , Jérôme Morel, Guillaume Y Millet
Affiliations

Factors Associated with Fatigue in COVID-19 ICU Survivors

Djahid Kennouche et al. Med Sci Sports Exerc. .

Abstract

Purpose: Approximately 30% of people infected with COVID-19 require hospitalization, and 20% of them are admitted to an intensive care unit (ICU). Most of these patients experience symptoms of fatigue weeks post-ICU, so understanding the factors associated with fatigue in this population is crucial.

Methods: Fifty-nine patients (38-78 yr) hospitalized in ICU for COVID-19 infection for 32 (6-80) d, including 23 (3-57) d of mechanical ventilation, visited the laboratory on two separate occasions. The first visit occurred 52 ± 15 d after discharge and was dedicated to questionnaires, blood sampling, and cardiopulmonary exercise testing, whereas measurements of the knee extensors neuromuscular function and performance fatigability were performed in the second visit 7 ± 2 d later.

Results: Using the FACIT-F questionnaire, 56% of patients were classified as fatigued. Fatigued patients had worse lung function score than non-fatigued (i.e., 2.9 ± 0.8 L vs 3.6 ± 0.8 L; 2.4 ± 0.7 L vs 3.0 ± 0.7 L for forced vital capacity and forced expiratory volume in 1 s, respectively), and forced vital capacity was identified as a predictor of being fatigued. Maximal voluntary activation was lower in fatigued patients than non-fatigued patients (82% ± 14% vs 91% ± 3%) and was the only neuromuscular variable that discriminated between fatigued and non-fatigued patients. Patient-reported outcomes also showed differences between fatigued and non-fatigued patients for sleep, physical activity, depression, and quality of life ( P < 0.05).

Conclusions: COVID-19 survivors showed altered respiratory function 4 to 8 wk after discharge, which was further deteriorated in fatigued patients. Fatigue was also associated with lower voluntary activation and patient-reported impairments (i.e., sleep satisfaction, quality of life, or depressive state). The present study reinforces the importance of exercise intervention and rehabilitation to counteract cardiorespiratory and neuromuscular impairments of COVID-19 patients admitted in ICU, especially individuals experiencing fatigue.

Trial registration: ClinicalTrials.gov NCT04363606.

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References

    1. Rooney S, Webster A, Paul L. Systematic review of changes and recovery in physical function and fitness after severe acute respiratory syndrome–related coronavirus infection: implications for COVID-19 rehabilitation. Phys Ther . 2020;100(10):1717–29.
    1. Bonny V, Maillard A, Mousseaux C, Plaçais L, Richier Q. COVID-19: physiopathologie d’une maladie à plusieurs visages. Rev Med Interne . 2020;41(6):375–89.
    1. Carfì A, Bernabei R, Landi F; Gemelli Against COVID-19 Post-Acute Care Study Group. Persistent symptoms in patients after acute COVID-19. JAMA . 2020;324(6):603–5.
    1. Townsend L, Dyer AH, Jones K, et al. Persistent fatigue following SARS-CoV-2 infection is common and independent of severity of initial infection. PLoS One . 2020;15(11):e0240784.
    1. Morel J, Infantino P, Gergelé L, Lapole T, Souron R, Millet GY. Prevalence of self-reported fatigue in intensive care unit survivors 6 months-5 years after discharge. Sci Rep . 2022;12(1):5631.

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