Change in Fatigue over 15 months in people the Post-Covid Syndrome

ObjectiveThe objective was to estimate unique patterns of change in fatigue in people with the Post-Covid Syndrome (PCS) over 15 months. Design/SubjectsThe Quebec Action for Post-COVID (QAPC) study was a prospective study designed to provide a patient-centered understanding of symptoms, function, and quality of life in a self-identified Quebec sample. MethodsParticipants were queried every 3 months about symptoms and function. Fatigue was measured with the 10-item Post-COVID Syndrome Fatigue Severity Measure with a transformed score ranging from 0 no fatigue to 100 extreme fatigue. Group Based Trajectory Analysis (GBTA) was used to identify patterns of longitudinal change. Results545 people had an average value of fatigue at baseline of 62.2 / 100 (SD: 21.6); 25% of the cohort had 5 visits. Six trajectories of individual change emerged: two groups with the highest fatigue showed persistence over time; a small group with high fatigue showed improvement; two groups with average fatigue showed improvement over time; and the group with low fatigue showed no emergence of this symptom, ConclusionHigh fatigue seems to persist over time while less severe fatigue abates. High fatigue may indicate a sub-syndrome within PCS similar to chronic fatigue syndrome. Lay AbstractThe Post-Covid syndrome (PCS) affected people world-wide and many people still suffer its long term effects. Fatigue is a defining symptom of PCS and there is no evidence-based treatment for this life altering symptom. Using a PCS specific measure of fatigue severity developed using modern measurement theory, six different patterns of longitudinal change were observed. People with the most severe fatigue showed no recovery over time except for a very small group who did recover. People with moderate fatigue showed some improvement. The notion that severe fatigue could be a separate clinical entity needs further study.