Long-Term Effects of Long-COVID: Severe Fatigue Symptoms

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Long-Term Effects of Long-COVID: Severe Fatigue Symptoms

Long-Term Effects of Long-COVID: Severe Fatigue Symptoms.

When patients continue to experience health issues three months after infection with the SARS-CoV-2 virus, with symptoms persisting for at least two months and no other explanations, it is termed “Post-COVID Syndrome” (PCS), also known as “Long COVID.”

Symptoms vary widely, with many individuals facing issues such as difficulty breathing, reduced concentration, or almost no stamina. Most PCS patients complain of fatigue, and normal rest and recovery hardly alleviate it.

In many cases, these individuals struggle to manage daily life, with even mild exertion exacerbating their condition, a phenomenon referred to as “exercise intolerance.”

This condition is significantly more prevalent in women than in men.

Patients and others naturally want to know how long these symptoms will last. Some research results have emerged about the initial months after infection.

Generally, the more severe the initial infection, the longer the recovery time required. Many, but unfortunately not all, see improvements in their symptoms within a year.

Thus far, the long-term progression of these patients’ conditions remains unclear.

Long-Term Effects of Long-COVID: Severe Fatigue Symptoms

Studying Severe Fatigue Symptoms After COVID:

A recent study primarily focused on patients who still experienced severe fatigue and exercise intolerance six months after SARS-CoV-2 infection.

Unlike studies solely based on patients’ descriptions of their symptoms, this study involved comprehensive medical examinations of 106 participants, the majority of whom were women, at three different time points over several months.

Dr. Judith Bellman-Strobl, a senior physician at the Neuroimmunology Outpatient Clinic of the Experimental and Clinical Research Center (ECRC), a joint institution of Charité – Universitätsmedizin Berlin and the Max Delbrück Center, and the last author of the study, stated, “Unfortunately, our data show that patients with severe fatigue from Post-COVID Syndrome continue to suffer even a year and a half after their initial infection. Only about half of them, the ones without all the ME/CFS symptoms, show gradual improvement in some of their symptoms.”

Distinguishing Types of Fatigue in PCS Patients:

Researchers observed last year that patients with long-term COVID and severe fatigue and exercise intolerance can be categorized into two groups. Some patients meet the diagnostic criteria for ME/CFS, a complex neuroimmune disease characterized primarily by severe fatigue, exercise intolerance, and symptom exacerbation after exertion, often leading to physical disability. The second group of patients has similar symptoms, but they are generally less severe and of shorter duration.

The new study indicates that over time, the latter group of patients experiences some improvement in their symptoms, not only in terms of fatigue but also in overall discomfort, pain, and attention difficulties. Their functional abilities often improve, with some even able to return to work. In contrast, symptoms in COVID-related ME/CFS patients hardly change, with very few exceptions.

“Seven out of 55 ME/CFS patients showed some improvement in their physical impairment,” explained Bellman-Strobl. “But we still cannot explain this, and we cannot find any medical commonalities.”

Long-Term Effects of Long-COVID: Severe Fatigue Symptoms

Grip Strength: A Potential Indicator?

Another phenomenon identified in the study that might help gauge the progression of those meeting ME/CFS diagnostic criteria in Post-COVID Syndrome is that these patients with stronger grip strength at the onset of illness tend to have milder symptoms 20 months later.

Professor Carmen Scheibenbogen, Acting Director of the Charité Institute of Medical Immunology and Director of the Charité Fatigue Center, explained, “Grip strength is not only a parameter for the severity at the onset of the disease, but it is also a predictive marker for the course of ME/CFS. Further research is needed to confirm its significance as a prognostic factor before we can use grip strength as a prognostic factor.”

“The World Health Organization estimates that around 36 million people in Europe already suffer from long-term chronic obstructive pulmonary disease. Most of them experience impairments in daily life, with many being unable to lead normal lives,” she explained. “Even before the pandemic, Europe had an estimated 3 million ME/CFS patients, and our data now suggest that this number has doubled due to the pandemic. Our research shows that the conditions of most ME/CFS patients remain severe. Besides intensifying the search for effective treatments, this means that we need to establish medical facilities quickly to provide multidisciplinary care to patients based on current scientific findings and clinical experience.”

Dr. Bellman-Strobl’s main advice to patients is to avoid overexertion, maintain a pace to conserve energy reserves. Tools that can help patients achieve this include fitness trackers or pedometers, heart rate monitors, activity logs, and relaxation exercises.

“Monitoring steps can prevent post-exertional malaise, meaning symptom worsening after exercise. The better patients pace themselves, the milder their symptoms. People should be very cautious in figuring out their exercise limits. Professional guidance helps prevent overexertion.”