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Risk for chronic fatigue soars among those who had COVID-19, study says

Nancy Rose cooks in her kitchen at home.
Nancy Rose, right, who contracted COVID-19 in 2021 and continues to exhibit long-haul symptoms including brain fog and memory difficulties, cooks for her mother in Port Jefferson, N.Y., in January 2022. Rose said many of her symptoms waned after she got vaccinated, though she still has bouts of fatigue and memory loss.
(John Minchillo / Associated Press)
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People who have had COVID-19 have a significantly higher risk of suffering chronic fatigue than those who haven’t had the disease, a new study published Wednesday shows.

“Our data indicate that COVID-19 is associated with a significant increase in new fatigue diagnoses,” according to the study, published by the Centers for Disease Control and Prevention in the journal Emerging Infectious Diseases.

“Physicians should be aware that fatigue might occur or be newly recognized [more than a year] after acute COVID-19,” the report said.

Specifically, the study looked at electronic health records of more than 4,500 patients in Washington state who had COVID-19 in 2020 and 2021 and compared them to patients who hadn’t had COVID. The study found the risk for chronic fatigue in those who had COVID was about four times the risk compared to people who hadn’t contracted COVID.

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Scientists also looked at a more broad definition of fatigue, which includes chronic fatigue as well as diagnoses of weakness and malaise. The study found that the risk of fatigue among COVID-19 patients was 68% higher among people who’d had COVID than those who hadn’t.

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Among the 4,589 COVID-19 patients in the study, scientists identified 434 as “incident fatigue cases,” in which the person was diagnosed with fatigue after recovering from COVID-19. Of those, 81 were also identified as having chronic fatigue, which is a subset of general fatigue.

The risk of chronic fatigue after COVID-19 was more common among women, older people and those who had other medical conditions, the study said.

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The report illustrates the continuing burden of long COVID long after the emergency phase of the pandemic has ended. CDC survey data from last year said that up to 15% of U.S. adults had ever experienced long COVID and up to 6% of were currently experiencing long COVID.

Among those who have suffered long COVID — regardless of whether the person was hospitalized — fatigue is often a symptom.

Researchers for this study decided to focus on fatigue among COVID-19 patients because the symptom plays such a central role among those suffering from long COVID.

People who developed fatigue after COVID-19 had “far worse clinical outcomes,” the report said. Among more than 400 patients who dealt with post-COVID fatigue, 25.6% were hospitalized at some point following an acute bout of COVID-19 during the study’s time frame. By contrast, only 13.6% of more than 4,000 patients who didn’t develop post-COVID fatigue were later hospitalized.

Patients who had post-COVID fatigue were also at a higher risk of dying than those who did not develop fatigue, the report said.

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The report also cautioned that doctors be alert for COVID patients who have a history of mood disorders; such patients “are also at increased risk for post-COVID-19 fatigue,” it said.

Doctors say the risk of long COVID is further reason to take prudent steps to avoid a coronavirus infection, including avoiding sick people, taking a test to verify a COVID-19 diagnosis and staying home if you are ill but asymptomatic. Masking up in crowded indoor settings, staying up to date on vaccinations and taking antiviral drugs like Paxlovid when experiencing COVID-19 symptoms may also help reduce the risk of long COVID.

People can get infected with coronavirus multiple times, the CDC said, and “each time a person is infected or reinfected ... they have a risk of developing long COVID.”

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