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Review
. 2024 Jul 17:11:1387499.
doi: 10.3389/fmed.2024.1387499. eCollection 2024.

Developing a clinical-pathological framework of long COVID-related fatigue applied to public safety workers

Adriana Lofrano-Porto  1   2 , Susanne D'Isabel  3 , Denise L Smith  3
Affiliations
Review

Developing a clinical-pathological framework of long COVID-related fatigue applied to public safety workers

Adriana Lofrano-Porto et al. Front Med (Lausanne). .

Abstract

In the wake of the COVID-19 pandemic, millions worldwide are still struggling with persistent or recurring symptoms known as long COVID. Fatigue is one of the most prevalent symptoms associated with long COVID, and for many it can be debilitating. Understanding the potential pathological processes that link fatigue to long COVID is critical to better guide treatment. Challenges with diagnosis and treatment are reviewed, recognizing that post-COVID fatigue does not always present with corroborating clinical evidence, a situation that is frustrating for both patients and healthcare providers. Firefighters are a group of public safety workers who are particularly impacted by long COVID-related fatigue. Firefighters must be able to engage in strenuous physical activity and deal with demanding psychological situations, both of which may be difficult for those suffering from fatigue. Disruption in public safety worker health can potentially impact community welfare. This review creates a framework to explain the clinical-pathological features of fatigue resulting from long COVID, addresses diagnosis and treatment challenges, and explores the unique impact fatigue may pose for public safety workers and their organizations.

Keywords: COVID-19; ME/CFS; PASC; fatigue; long COVID; post-COVID conditions; public health; public safety.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Clinical-pathological framework of long-COVID-related fatigue. (A) Potential pathological mechanisms leading to long COVID; (B) Major phenotypes and symptom clusters with fatigue central to all phenotypes and often existing as a cardinal manifestation itself; (C) Proposed initial diagnostic stratification of long COVID patients according to clinical evidence of organ damage and/or dysfunction; (D) Impact of fatigue on public health and safety.
Figure 2
Figure 2
Proposed clinical flow sheet to guide, diagnose and treat long COVID-related fatigue.
See this image and copyright information in PMC

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