— Study finds little reason for optimism about long-term outlook

By John Gever

New studies confirm that fatigue remains the most common feature of so-called long COVID-19, and in a substantial fraction it is the most stubborn.

In fact, researchers are finding that a diagnosis of chronic fatigue — with all that implies — appears inevitable for many.

Among 239 individuals belonging to online support groups for “long COVID,” 178 (85%) said they had severe fatigue when surveyed 11 weeks after symptom onset, according to Maarten Van Herck, a PhD student at the University of Hasselt in the Netherlands, who spoke at the European Respiratory Society’s virtual annual meeting.

At week 24, the fraction indicating they suffered from severe fatigue stood at 79% — with 15 of the 35 who said they had mild or no fatigue at week 11 now saying it was severe, even as 31 of the 178 with initially severe fatigue reported it had become milder or disappeared.

Responses to survey items on specific fatigue symptoms showed an even distribution between mental and physical features.

Perhaps most alarming was that, by week 24, most of the cohort had consulted at least one medical professional as well as one or more allied specialists such as physiotherapists, psychologists, or dietitians — yet most of those with severe fatigue apparently had no benefit.

Only a few — 4% at week 11 and 13% at week 24 — had received formal rehabilitation therapy.

“A large share is progressing toward chronic fatigue,” said Van Herck, defined as severe fatigue lasting more than 6 months. And, he added, “it remains unclear whether and to what extent fatigue will resolve spontaneously” as time goes on.

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