Severe, persistent, disruptive fatigue higher in young women among community-based post SARS-CoV-2 study

Research Objectives: To describe the most likely persistent symptoms of PASC, their natural history, and the profile of those likely affected.

Design: Prospective, longitudinal design (baseline, 6 month, and annual follow-up visits), with 2 arms: virtual and in-person.

Setting: A large, metropolitan community health system in the Northeastern U.S.

Participants: 323 participants treated for SARS-CoV-2.

Interventions: Observational study.

Main Outcome Measures: SARS-CoV-2 history and treatment, PASC symptom reporting, socio-demographic variables, past medical history (PMH), patient-reported outcome measures (PROs; including FACIT-F fatigue, ESAS, EQ5D), cognitive tests (Color-Word Interference Test, Arithmetic, Matrix Reasoning), health behavior reporting. In-person subjects also had physical exams, grip strength, bioimpedance, 2-minute walk distance (2MWD), and blood draw.

Results: 323 participants completed baseline symptom reporting, of whom 61 participants indicated they had clinically significant fatigue (23.1% of overall cohort reporting baseline symptoms). 141 subjects also completed in-depth baseline questionnaires, including the FACIT-F fatigue, with 37 scoring in the severe fatigue range. This group- the entire severe fatigue cohort- was statistically significantly younger, female, had more anxiety and depression, had a higher resting heart rate, reported more sick days, and were less physically active post-COVID. The severely fatigued reported that their overall health, diet, weight, and uninterrupted sleep were worse than those not severely fatigued post-COVID (p=0.02-0.0002). The significantly fatigued group also had lower wellbeing scores, more depressive symptoms, and a greater number of all symptoms. Fatigue was statistically significantly correlated with all PROs administered but did not correlate with cognitive performance.

Conclusions: Fatigue is a common symptom associated with lower PRO scores of wellbeing and function. Those severely fatigued were younger, female, and have a past medical history of anxiety, depression, chronic kidney disease and physical inactivity.

Author(s) Disclosures: ZM Younossi- consulting fees: Bristol Myers Squibb, Gilead, Intercept, Novo Nordisk, Novartis, Terns, Merck, Quest, Siemens and Madrigal. All other authors: Nothing to disclose.