Study links persistent covid fatigue to anxiety and depression for the first time

A team of researchers from the Universitat Oberta de Catalunya (UOC) and of the Hospital de la Santa Creu i Sant Pau (Barcelona). has revealed the close relationship between fatigue, depression, anxiety and other cognitive deficits in patients with persistent covid. “Persistent fatigue is a very disabling thing and greatly limits people’s quality of life. If a person suffers from covid fatigueit is important to go further and see what other symptoms or disorders are associated with this condition,” according to Marco Calabriaprincipal investigator of the article

Fatigue, shortness of breath or cognitive dysfunction.are the most common symptoms of persistent covid, as defined by the World Health Organization (WHO). Symptoms must be present for at least two months and three months after the onset of the disease in order to be considered direct sequelae of the coronavirus. A recent study with the participation of the UOC -published in the scientific journal Brain and Behavior- showed that the disease generates a widespread impact on attention skills, executive functions, learning and long-term memory.

In fact, they explain from the UOC, the scientific literature estimates that between 9 % and 49 % of the patients. present fatigue four weeks after of symptom onset, and may even persist for a year in at least, one-third of patients. However, whether or not there was a connection between fatigue and anxiety or depression in patients with persistent covid was something that had not been studied.

A close relationship

Now, research by the Universitat Oberta de Catalunya, published openly in the. Journal of Neurologyreveals that fatigue in postcovid patients is associated with anxiety, depression, and apathy. “Persistent fatigue is a very disabling and greatly limits people’s quality of life. If a person suffers from covid fatigue, it is important to go further and see what other symptoms or disorders are associated with this condition,” according to Marco Calabria, lead researcher on the paper, member of the UOC’s Cognitive NeuroLab group and professor of Health Sciences Studies.

The scientists studied 136 patients with coronavirus suffering from cognitive deficits eight months after contracting the virus. They found that fatigue is associated “with sustained attention, which we use to perform a task for a long time and keeps us focusedas well as with executive functions, which allow us to keep information temporarily stored so that we can perform tasks such as calculating or reworking a sentence we have heard”.

Known link between fatigue and depression.the researcher Marco Calabria underlines that “clinicians should explore these aspects to guide therapeutic guidelines”. But one thing the research he leads has not clarified is the direction of the effect: “It is not clear whether it is fatigue that generates depression or the other way around,” he explains.

The effects of the pandemic

Fatigue is characterized by by excessive fatigue and physical or cognitive and muscular weakness. It has been associated with medical conditions such as postviral infections or neurological diseases. But, although it could be so broadly drawn, there is no universally accepted definition of this clinical condition, and what knowledge there is of its underlying pathogenic mechanism is limited, so that it represents a clinical challenge for experts.

Another challenge for the team of scientists was to separate postcoviral fatigue from the impact experienced during the pandemic. “Fatigue is a symptom related to viral infections and this indicated to us that it would be one of the possible symptoms of SARS-CoV-2 infection,” explains Calabria, for whom it is possible that, in the early waves of the pandemic, isolation contributed to to increase some symptoms.

However, some observations indicated to them that this is not always the case: for many people, fatigue prevents them from returning to the life they had before; others continue to suffer from this fatigue even though they may have been able to return to pre-pandemic conditions; and, in the case of coronavirus-associated apathy, the researchers were able to find that its prevalence went from 17% before infection to 62% after infection.

Many unanswered questions

The results of the study emphasize the importance of a holistic approach to evaluate and consider potential treatment for covid-19 patients experiencing fatigue. But, they caution, many questions remain to be answered. For example, notes the principal investigator of the study, how these changes are reflected at the brain level, how long they last, who is more susceptible to suffer from these symptoms for a long time Or what are the individual characteristics that predict a recovery. All these questions, he concludes, will be answered as time goes on, “because we are dealing with something new and unknown.”.

In the latest report of the Multidisciplinary Working Group (MDWG), which advises the. Ministry of Science and supports the Government in scientific matters related to covid-19 since the onset of the pandemic, it is estimated that over of one million people may develop persistent covid in Spain, associated in the majority of cases with symptoms such as fatigue and headacheand although it can affect all groups who have had the disease, the most likely candidates are adults between 30 and 50 years of age and women.