Fatigue presentation, severity, and related outcomes 12 weeks post-COVID-19 hospitalization

Background Increasing evidence on long-term health outcomes following SARS CoV-2 infection shows post-viral symptoms can persist for months. The aim of the present study was to examine the prevalence and outcome predictors of post-viral fatigue and related symptoms 3 and 6 months following infection. Methods A prospective cohort of patients hospitalized with COVID-19 (n=88) were recruited from a Post-COVID-19 Respiratory Clinic (PCRC) in Vancouver, Canada to examine predictors of long-term fatigue and substantial fatigue. Multivariable logistic and linear regression analysis were used to examine the relationship between patient predictors (medical history at the time of hospitalization and follow-up patient-reported outcome measures) and the presentation of fatigue and substantial fatigue at 3 and 6 months follow-up. Results The number of patients exhibiting fatigue and substantial fatigue was 58 (67%) and 14 (16%) at 3 months and 47 (60%) and 6 (7%) at 6 months post-infection, respectively. Adjusted analysis revealed the number of pre-existing comorbidities to be associated with fatigue (OR 2.21; 95% CI 1.09-4.49; 0.028) and substantial fatigue (OR 1.73; 95% CI 1.06-2.95; 0.033) at 3 months follow-up. Except for shortness of breath, self-care, and time, all follow-up variables were found to be associated with fatigue and substantial fatigue at 3 months follow-up. Conclusion Fatigue and substantial fatigue are common, and decrease from 3 to 6 months; however, a significant number of patients continue to exhibit long-term fatigue at 6 months follow-up. Further research is needed to clarify the causality of viral infections and co-factors in the development and severity of fatigue as a symptom and in meeting post-viral fatigue syndrome or ME/CFS diagnostic criteria. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study did not receive any funding ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethics committee of University of British Columbia gave ethical approval for this work I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors