Postinfectious fatigue: prospective cohort study in primary care

Area of Science:

• General Practice
• Infectious Disease Epidemiology
• Psychiatry

Background:

• The link between infections and chronic fatigue is often suggested but based on biased retrospective studies.
• Prospective research is needed to clarify the relationship between infections and the development of chronic fatigue.

Purpose of the Study:

• To prospectively investigate the association between clinically diagnosed infections and the subsequent development of chronic fatigue.
• To identify predictors of post-infectious fatigue in primary care settings.

Main Methods:

• A prospective cohort study involving patients aged 18-45 presenting to UK general practitioners with infections or for other reasons.
• Assessment of fatigue and psychiatric morbidity via questionnaires at baseline and 6-month follow-up.
• Comparison of chronic fatigue and chronic fatigue syndrome prevalence between infected individuals and controls.

Main Results:

• No significant difference in chronic fatigue prevalence (9.9% vs 11.7%) or chronic fatigue syndrome criteria between infection cases and controls.
• Pre-existing fatigue and psychological distress were identified as the strongest predictors of post-infectious fatigue.
• Excluding individuals with baseline fatigue or psychological morbidity removed any observed association with infection.

Conclusions:

• Common infections presenting in primary care do not appear to be a cause of chronic fatigue or chronic fatigue syndrome.
• Pre-existing psychological factors and fatigue levels are more significant predictors of developing persistent fatigue after an infection.