A prospective observational study of post-COVID-19 chronic fatigue syndrome following the first pandemic wave in Germany and biomarkers associated with  symptom severity

Abstract

A subset of patients has long-lasting symptoms after mild to moderate Coronavirus disease 2019 (COVID-19). In a prospective observational cohort study, we analyze  clinical and laboratory parameters in 42 post-COVID-19 syndrome patients (29  female/13 male, median age 36.5 years) with persistent moderate to severe fatigue  and exertion intolerance six months following COVID-19. Further we evaluate an  age- and sex-matched postinfectious non-COVID-19 myalgic  encephalomyelitis/chronic fatigue syndrome cohort comparatively. Most  post-COVID-19 syndrome patients are moderately to severely impaired in daily  live. 19 post-COVID-19 syndrome patients fulfill the 2003 Canadian Consensus  Criteria for myalgic encephalomyelitis/chronic fatigue syndrome. Disease severity  and symptom burden is similar in post-COVID-19 syndrome/myalgic  encephalomyelitis/chronic fatigue syndrome and non-COVID-19/myalgic  encephalomyelitis/chronic fatigue syndrome patients. Hand grip strength is  diminished in most patients compared to normal values in healthy. Association of  hand grip strength with hemoglobin, interleukin 8 and C-reactive protein in  post-COVID-19 syndrome/non-myalgic encephalomyelitis/chronic fatigue syndrome and  with hemoglobin, N-terminal prohormone of brain natriuretic peptide, bilirubin,  and ferritin in post-COVID-19 syndrome/myalgic encephalomyelitis/chronic fatigue  syndrome may indicate low level inflammation and hypoperfusion as potential  pathomechanisms.