‘Psychosocially vulnerable’ patients at higher risk of long Covid fatigue

Psychosocially vulnerable individuals are more at risk of developing long Covid associated persistent fatigue after Covid-19 infection, research suggests.

An analysis of Dutch GP patient records during the first wave of the pandemic found those with suspected Covid-19 infections were four times more likely to have persistent fatigue than those who had not been infected.

The study, which looked at fatigue at three, six and 15 months after initial infection, found an association with several psychosocial factors and risk of fatigue.

Among those who had suspected Covid-19, those with a lower level of education were three times more likely to report persistent fatigue as were those who did not have a partner.

High frequency of GP contact in the previous year and polypharmacy were also associated with a 2.7 and 3.5 increased risk of persistent fatigue respectively, the researchers reported in the British Journal of General Practice.

Links were also found with individuals who scored more highly on a rating of neuroticism and those who had lower resilience scores or who had a high number of ‘life events’ in the past 12 months.

Overall, of the 300 patients included in the study, 56%, 57%, and 48% of the suspected Covid-19 group were classified as fatigued, compared with 30%, 25%, and 31% in the non-Covid-19 group at 3, 6, and 15 months.

Contrary to other studies, the researchers found no increased risk of persistent fatigue among female patients or those with obesity.

They also found no association with chronic comorbidities and persistent symptoms after Covid-19 infection.

It follows a large study published recently which found that most patients with long Covid after an initial mild infection will see resolution of symptoms within a year.

Taken together ‘these results seem to indicate that psychosocially vulnerable patients are more likely to report persistent fatigue after Covid-19 infection’, the researchers said.

More work is needed to investigate the prognostic factors identified in the study, they added, but this information could help the GP to provide holistic care to the patient.

‘When a patient has Covid-19 infection and meets some of the prognostic psychosocially vulnerable criteria, the GP should be aware of the increased risk of persistent fatigue and adapt the treatment plan to prevent its development,’ they concluded.

A version of this article first appeared in our sister paper Pulse