{"id":27129,"date":"2020-07-22T06:49:32","date_gmt":"2020-07-22T06:49:32","guid":{"rendered":"https:\/\/wames.org.uk\/cms-english\/?p=27129"},"modified":"2020-07-22T06:57:26","modified_gmt":"2020-07-22T06:57:26","slug":"coronavirus-why-are-some-people-experiencing-long-term-fatigue","status":"publish","type":"post","link":"https:\/\/wames.org.uk\/cms-english\/coronavirus-why-are-some-people-experiencing-long-term-fatigue\/","title":{"rendered":"Coronavirus: why are some people experiencing long-term fatigue?"},"content":{"rendered":"

The Conversation<\/strong> blog post: Coronavirus: why are some people experiencing long-term fatigue?<\/a>, by Prof Frances Williams, 16 July 2020<\/h3>\n

 <\/p>\n

\"\"People who have been seriously unwell and treated on intensive care units can expect to take some months to recover fully, regardless of their ailment. However, with COVID-19, evidence is mounting that some people who have had relatively mild symptoms at home may also have a prolonged illness. Overwhelming fatigue, palpitations, muscle aches, pins and needles and many more symptoms are being\u00a0reported as after-effects<\/a> of the virus. Around 10% of the 3.9 million people contributing to the\u00a0COVID Symptom Study app<\/a>\u00a0have effects lasting more than four weeks.<\/p>\n

Chronic fatigue \u2013 classified as fatigue lasting more than six weeks \u2013 is recognised in many different clinical settings, from cancer treatment to inflammatory arthritis. It can be disabling. If 1% of the 290,000 or so people who have had COVID-19 in the UK remain under the weather at three months, this will mean thousands of people are unable to return to work. They will probably have complex needs that the NHS is ill-prepared to address at present.<\/p>\n

COVID-19 is not the only cause of chronic fatigue. Prolonged fatigue is well recognised after other viral infections such as the\u00a0Epstein-Barr virus<\/a>, which causes infectious mononucleosis (also known as glandular fever). Post-viral fatigue was also seen in a quarter of those infected with the\u00a0original Sars viru<\/a>s\u00a0in Hong Kong in 2003.<\/p>\n

When it comes to treating chronic fatigue, the emphasis previously has been on effective treatment of the underlying disease, in the belief that this would diminish the fatigue. However, for most viral infections there is no specific treatment, and because COVID-19 is so new, we don\u2019t yet know how to manage post-COVID fatigue.<\/p>\n

What might be causing post-COVID fatigue?<\/strong><\/p>\n

Although we know that lasting fatigue can sometimes follow other viral infections, detailed mechanistic insight is, for the most part, lacking. An ongoing viral infection in lung, brain, fat or other tissue may be one mechanism. A prolonged and inappropriate immune response after the infection has been cleared might be another.<\/p>\n

However,\u00a0a previous study<\/a>\u00a0has given us some insight. When a chemical called interferon-alpha was given to people as a treatment for hepatitis C, it generated a flu-like illness in many patients and post-viral fatigue in a few. Researchers have studied this \u201cartificial infection response\u201d as a model of chronic fatigue. They found that baseline levels of two molecules in the body that promote inflammation \u2013 interleukin-6 and interleukin-10 \u2013 predicted people\u2019s subsequent development of chronic fatigue.<\/p>\n

Of particular interest, these same pro-inflammatory molecules are seen in the\u00a0\u201ccytokine storm<\/a>\u201d\u00a0of severely ill COVID-19 patients. This suggests there might be a pattern of immune system activation during the viral infection that is relevant to ongoing symptoms. Further support for interleukin-6 playing some sort of role comes from the\u00a0successful use\u00a0of tocilizumab<\/a> \u2013 a treatment that lessens the impact of interleukin-6 and reduces inflammation \u2013 to treat severe COVID-19.<\/p>\n

Read the full article<\/a><\/strong> for info about Covid-19 research at Kings College, London and the need to pace when managing chronic fatigue. Prof Williams recommends Dr Muirhead’s ME\/CFS course for clinicians at StudyPRN.<\/p>\n","protected":false},"excerpt":{"rendered":"

The Conversation blog post: Coronavirus: why are some people experiencing long-term fatigue?, by Prof Frances Williams, 16 July 2020   People who have been seriously unwell and treated on intensive care units can expect to take some months to recover … Continue reading →<\/span><\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[1],"tags":[9,6073,6075,5821,6072,6074],"class_list":["post-27129","post","type-post","status-publish","format-standard","hentry","category-news","tag-chronic-fatigue","tag-cytokine-storm","tag-immune-system-activation","tag-post-covid-19-fatigue","tag-prof-frances-williams","tag-tocilizumab"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p5qkYK-73z","_links":{"self":[{"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/posts\/27129","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/comments?post=27129"}],"version-history":[{"count":4,"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/posts\/27129\/revisions"}],"predecessor-version":[{"id":27180,"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/posts\/27129\/revisions\/27180"}],"wp:attachment":[{"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/media?parent=27129"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/categories?post=27129"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/tags?post=27129"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}