Factors Associated with Post-Exertion Malaise in Patients Suffering from Post-COVID-19 Syndrome
Year: 2025
Type: article
Study design: Observational Study
Abstract: Background: Some, but not all, of patients experiencing Post-COVID-19 Syndrome (PCS) develop Post-Exertional Malaise (PEM) and meet criteria of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS).PEM is associated with a poor outcome in ME/CFS patients.We attempted to identify potential factors associated with PEM occurrence in PCS patients, and to assess the prognosis of PCS patients with and without PEM.Methods: We retrospectively included patients meeting the World Health Organization definition of PCS who attended the post-COVID clinic at the Internal Medicine Department of Angers University Hospital, France, between June 2020 and June 2024.We reviewed their medical records and gathered data including epidemiological characteristics and information concerning COVID-19 infection, PEM features, fatigue severity, and work-related outcomes.Results: The included 281 PCS patients were classified into 2 groups according to the presence or not of PEM.Factors that persisted to be positively associated with PEM on multivariate analysis were: COVID onset in 2020/2021 (OR 2.75 [95% CI: 1.04-7.25],p=0.04),POTS (OR 4.38 [95% CI: 1.43-13.38],p=0.01), and high fatigue levels (OR 1.93 [95% CI: 1.34-2.78],p<0.001).The follow-up assessment showed that PCS patients with PEM had significant higher fatigue levels in (5.2 [4.3-5.8] vs. 4.7 [3.8-5.3],p=0.002), and lower recovery/improvement rates (30/58 (51.7%) vs. 127/162 (78.4%), p<0.001).Conclusion: PEM was more prevalent in PCS patients with COVID onset in the pre-omicron era, and was associated with post-COVID POTS and a poor prognosis.Consequently, PEM and autonomic dysfunction, particularly POTS, should be systematically screened in PCS patients.
Language: English
Subfield: Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4407338867