Skip to main content

Main menu

  • Home
  • Our journals
    • Clinical Medicine
    • Future Healthcare Journal
  • Subject collections
  • About the RCP
  • Contact us

Clinical Medicine Journal

  • ClinMed Home
  • Content
    • Current
    • Ahead of print
    • Archive
  • Author guidance
    • Instructions for authors
    • Submit online
  • About ClinMed
    • Scope
    • Editorial board
    • Policies
    • Information for reviewers
    • Advertising

User menu

  • Log in

Search

  • Advanced search
RCP Journals
Home
  • Log in
  • Home
  • Our journals
    • Clinical Medicine
    • Future Healthcare Journal
  • Subject collections
  • About the RCP
  • Contact us
Advanced

Clinical Medicine Journal

clinmedicine Logo
  • ClinMed Home
  • Content
    • Current
    • Ahead of print
    • Archive
  • Author guidance
    • Instructions for authors
    • Submit online
  • About ClinMed
    • Scope
    • Editorial board
    • Policies
    • Information for reviewers
    • Advertising

Persistent fatigue in patients with COVID-19

Chia Siang Kow and Syed Shahzad Hasan
Download PDF
DOI: https://doi.org/10.7861/clinmed.Let.21.1.3
Clin Med January 2021
Chia Siang Kow
International Medical University, Kuala Lumpur, Malaysia
Roles: Research fellow
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Syed Shahzad Hasan
University of Huddersfield, Huddersfield, UK and University of Newcastle, Callaghan, Australia
Roles: Senior research fellow
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Info & Metrics
Loading

Editor – We read with interest the review by Sullivan who described the long-term sequela of patients who acquired severe acute respiratory syndrome coronavirus infection and Middle East respiratory syndrome coronavirus infection.1 Based on the previous experiences with the two epidemics, the author suggested that patients who recovered from COVID-19 may also suffer from the similar long-term complications which include cardiopulmonary sequelae and fatigue.

We wish to discuss the condition of persistent fatigue following the recovery of COVID-19. In fact, available studies have reported fatigue as the most prevalent symptom that persists in patients who recovered from COVID-19, which has now been termed as ‘long COVID’. An Italian study of 179 patients reported that 87.4% of patients had persistence of at least one symptom in 60 days after their initial COVID-19 diagnosis, with fatigue being the most prevalent symptom (53.1%).2 Likewise, Townsend et al which evaluated 128 patients who recovered from the acute phase of COVID-19 reported persistent fatigue in 52.3% of patients at 10 weeks after initial symptoms.3 Moreover, an analysis of data from 4,182 incident cases of COVID-19 logged in the COVID Symptom Study app revealed that 13.3% of cases had symptoms lasting >28 days, with fatigue being the most commonly reported symptom (97.7%) among those who had long COVID.4

We agree with Sullivan that clinicians will need to monitor for long-term complications in patients who recover from COVID-19, especially persistence of fatigue.1 In patients who are particularly troubled with persistent fatigue, drug therapy including glucocorticoids and methylphenidate could be offered on a case-by-case basis after evaluating risks and benefits. A double-blind, randomised, placebo-controlled trial of 25–35 mg/day of oral hydrocortisone for 12 weeks in 70 patients with chronic fatigue syndrome (CFS) showed modest improvement at the expense of adrenal suppression.5 In another randomised crossover trial, improvement in fatigue level was observed in response to 5–10 mg/day of hydrocortisone among 32 CFS patients.6 A double-blind, randomised, placebo-controlled crossover study of 60 CFS patients evaluated treatment with methylphenidate (10 mg twice daily) compared with placebo and reported clinical improvement in 17% of patients.7

  • © Royal College of Physicians 2021. All rights reserved.

References

  1. ↵
    1. O’Sullivan O
    . Long-term sequelae following previous coronavirus epidemics. Clin Med 2021;21:e68–70.
  2. ↵
    1. Carfì A
    , Bernabei R, Landi F, Gemelli Against COVID-19 Post-Acute Care Study Group. Persistent symptoms in patients after acute COVID-19. JAMA 2020;324:603–5.
    OpenUrlCrossRefPubMed
  3. ↵
    1. Townsend L
    , Dyer AH, Jones K, et al. Persistent fatigue following SARS-CoV-2 infection is common and independent of severity of initial infection. PLoS One 2020;15:e0240784.
    OpenUrl
  4. ↵
    1. Sudre CH
    , Murray B, Varsavsky T, et al. Attributes and predictors of long-COVID: analysis of COVID cases and their symptoms collected by the COVID Symptoms Study app. medRxiv 2020.10.19.20214494.
  5. ↵
    1. McKenzie R
    , O’Fallon A, Dale J, et al. Low-dose hydrocortisone for treatment of chronic fatigue syndrome: a randomized controlled trial. JAMA 1998;280:1061–6.
    OpenUrlCrossRefPubMed
  6. ↵
    1. Cleare AJ
    , Heap E, Malhi GS, et al. Low-dose hydrocortisone in chronic fatigue syndrome: a randomised crossover trial. Lancet 1999;353:455–8.
    OpenUrlCrossRefPubMed
  7. ↵
    1. Blockmans D
    , Persoons P, Van Houdenhove B, Bobbaers H. Does methylphenidate reduce the symptoms of chronic fatigue syndrome? Am J Med 2006;119:167.e23–30.
    OpenUrlCrossRefPubMed
Back to top
Previous articleNext article

Article Tools

Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Citation Tools
Persistent fatigue in patients with COVID-19
Chia Siang Kow, Syed Shahzad Hasan
Clinical Medicine Jan 2021, 21 (1) e117; DOI: 10.7861/clinmed.Let.21.1.3

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Persistent fatigue in patients with COVID-19
Chia Siang Kow, Syed Shahzad Hasan
Clinical Medicine Jan 2021, 21 (1) e117; DOI: 10.7861/clinmed.Let.21.1.3
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • References
  • Info & Metrics

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • Cardiac investigations after ischaemic stroke
  • Bias in the COVID-19 era
  • Stop auscultating and listen carefully instead: the new era of respiratory medicine
Show more Letters to the editor

Similar Articles

Navigate this Journal

  • Journal Home
  • Current Issue
  • Ahead of Print
  • Archive

Related Links

  • ClinMed - Home
  • FHJ - Home
clinmedicine Footer Logo
  • Home
  • Journals
  • Contact us
  • Advertise
HighWire Press, Inc.

Follow Us:

  • Follow HighWire Origins on Twitter
  • Visit HighWire Origins on Facebook

Copyright © 2021 by the Royal College of Physicians