Post-viral fatigue and COVID-19: lessons from past epidemics, by Mohammed F Islam, Joseph Cotler,  & Leonard A Jason in Fatigue: Biomedicine, Health & Behavior 25 Jun 2020 []


Review Abstract:

The COVID-19 pandemic, resulting from Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), has severely impacted the population worldwide with a great mortality rate.

The current article reviews the literature on short- and long-term health consequences of prior epidemics and infections to assess potential health complications that may be associated with post-COVID-19 recovery.

Past research on post-epidemic and post-infection recovery has suggested that such complications include the development of severe fatigue. Certain factors, such as the severity of infection, in addition to the ‘cytokine storm’ experienced by many COVID-19 patients, may contribute to the development of later health problems.

We suggest that the patterns observed in past epidemics and infections may re-occur in the current COVID-19 pandemic.

Excerpts from Concluding remarks:

Past research has shown that elevated levels of post-infectious fatigue are common for some survivors of epidemics such as SARS and Ebolavirus. Chronic widespread musculoskeletal pain, fatigue, depression and disorder sleep in chronic post-SARS syndrome; a case-controlled study.  Post-Ebola syndrome among Ebola virus disease survivors in Monsterraro county, Liberia 2016. Moreover, fatigue has been associated with infections, such as infectious mononucleosis, that occur frequently outside of an epidemic or pandemic scale. Chronic fatigue syndrome following infections in adolescents.

These types of outcomes are not limited to just viral infections, but also bacterial infections. Post-infective and chronic fatigue syndromes precipitated by viral and non-viral pathogens: prospective cohort study. Given such evidence, we expect that some survivors of COVID-19 will develop post-infectious fatigue and other complications.

… Since the start of the epidemic, enough time has not elapsed to study the long-term trajectory of COVID-19, but reports are emerging about the occurrence of serious potentially longer-term health consequences. For example, several patients in Italy have developed Guillain-Barré.  There are reports of children developing Kawasaki disease, and other reports of COVID-19 causing lung scarring, blood clots, renal failure, and neurological complications.  Shi et al. found 19% of 416 hospitalized COVID-19 patients showed signs of heart damage. These types of findings of COVID-19 reinforce our contention that a portion of survivors will experience a variety of longer-term health complications including post-infectious fatigue.

ME Research UK: COVID-19 – should we expect an increase in ME/CFS cases?  7 Jul 2020



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