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Review
. 2025 Oct 5;17(10):e93877.
doi: 10.7759/cureus.93877. eCollection 2025 Oct.

Long COVID-Related Fatigue During Pregnancy: A Systematic Review

Aikaterini Dimitrakopoulou  1 , Antigoni Sarantaki  1 , Christina I Nanou  1 , Vasiliki E Georgakopoulou  2 , Chrysoula Taskou  1 , Maria Chouli  1 , Athina Diamanti  1
Affiliations
Review

Long COVID-Related Fatigue During Pregnancy: A Systematic Review

Aikaterini Dimitrakopoulou et al. Cureus. .

Abstract

Long sequelae of COVID-19 (Long COVID), or post-acute sequelae of SARS-CoV-2 infection, encompasses a wide range of persistent symptoms, with fatigue emerging as one of the most prevalent and disabling. Pregnant individuals may be uniquely susceptible to post-viral fatigue due to immunological and physiological adaptations during gestation. This review consolidates existing data regarding the prevalence, risk factors, and clinical implications of Long COVID-associated fatigue in pregnant individuals. A narrative review was conducted of studies examining fatigue among pregnant individuals with confirmed SARS-CoV-2 infection. Key outcomes included fatigue prevalence, symptom persistence, associated risk or protective factors, and comparisons with non-pregnant populations. Across both the acute and post-acute stages of COVID-19, fatigue emerged as a consistently common symptom. Its prevalence and persistence varied significantly across studies, partly due to heterogeneity in assessment tools and follow-up durations. Severe acute illness, hospitalization, obesity, and smoking during pregnancy were linked to a higher risk of prolonged fatigue, whereas anosmia appeared to act as a potential protective factor. In contrast, comorbidities such as hypertension, diabetes, and lung disease were not significantly linked to fatigue risk. No consistent associations were found with maternal age or alcohol use. Long COVID-related fatigue presents a substantial burden in pregnancy, with implications for maternal health, quality of life, and postpartum recovery. Early recognition, individualized care strategies, and public health interventions targeting modifiable risk factors are essential to support this vulnerable population. Ongoing research is essential to uncover underlying mechanisms and guide evidence-based clinical management.

Keywords: fatigue; long covid-19; post-viral sequelae; pregnancy; sars-cov-2.

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Conflict of interest statement

Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Flowchart of the study selection process.
Figure 2
Figure 2. Risk and protective factors for Long COVID fatigue in pregnancy.
The image was created by the authors of this article.
See this image and copyright information in PMC

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