Multidimensional Characterization of Long COVID Fatigue.

Area of Science:

• Neuroscience
• Sleep Medicine
• Infectious Diseases

Background:

• Post-acute sequelae of SARS-CoV-2 infection (PASC), commonly known as long COVID, presents with persistent, disabling symptoms.
• Fatigue is a predominant and often debilitating symptom in PASC patients, significantly impacting quality of life.

Purpose of the Study:

• To characterize the phenotype of PASC fatigue through a multidimensional analysis.
• To investigate the associations between fatigue severity and mood, cognition, sleep, and circadian rhythms in PASC patients.

Main Methods:

• Recruited adult PASC patients from a Neuro-COVID-19 Clinic.
• Assessed self-reported symptoms using Patient-Reported Outcomes Measurement Information System (PROMIS) instruments.
• Evaluated cognitive performance with NIH Toolbox measures, sleep, and rest-activity rhythms via 7-day wrist actigraphy, and polysomnography in a subset.

Main Results:

• Fatigue severity correlated with worse subjective cognitive abilities, depression symptoms, disrupted rest-activity patterns, and increased sleep time.
• Objective cognitive performance was not significantly correlated with fatigue severity.
• Multivariable analysis identified independent associations between fatigue and subjective cognition, depression, and circadian rhythm disruption.

Conclusions:

• Long sleep times, disrupted circadian patterns, depression, and subjective cognitive impairment are associated with PASC fatigue.
• Behaviorally influenced sleep and circadian abnormalities may exacerbate PASC fatigue and represent potential therapeutic targets.