Long COVID May Cause Fatigue, Brain Fog, Poor Sleep, Study Finds

Patients may experience symptoms related to post-acute COVID syndrome (PACS), also referred to as “long COVID,” for at least 12 months after initial COVID-19 infection, according to a recent study.¹

The research, published in the American Journal of Physical Medicine and Rehabilitation, also demonstrated the negative impacts of PACS symptoms on physical function, cognitive function, health-related quality of life, and participation.^1,2 The study is one of the first to measure the impairment and impact of PACS on patients and note the factors that exacerbate symptoms.²

PACS is one of the most troubling manifestations of severe COVID-19 infection and can last for several months, according to investigators.¹ “Despite the highly debilitating nature of PACS, the long-lasting symptoms often occur in the absence of severe acute infections, medically explainable physical symptoms, or pre-existing comorbidities,” the authors wrote.

Recent studies have identified the most common persistent symptoms of severe COVID-19 infection. These include:

• Fatigue
• Dyspnea
• “Brain fog”/various cognitive symptoms
• Pain
• Anxiety
• Depression
• Gastrointestinal issues

Researchers have observed that a COVID-19 infection acts like an immune trigger, which may be the cause of the persistent symptoms.

The cross-sectional, observational study surveyed a total of 156 patients who were not yet vaccinated for COVID-19 at the Mount Sinai PACS Clinic between March 2020 and March 2021.

Among the survey respondents, 82% reported fatigue (n=128), 67% said they experienced brain fog (n=105), 60% suffered headaches (n=94), 59% experienced sleep disturbance (n=92), and 54% reported dizziness (n=85).

Physical exertion (86%), stress (69%), and dehydration (49%) were the most common triggers of symptom exacerbation, the researchers found. Other triggers included weather changes (37%), consuming large meals (28%), premenstrual period (22%), and alcohol consumption (22%).

Investigators also reported that 78% of patients indicated problematic fatigue, and 40% of patients showed moderate to severe disability due to dyspnea. Compared with pre-COVID-19 infection, patients were completing at least 150 minutes per week of physical activity on a less frequent basis.

Sixty-three percent of patients indicated experiencing at least mild cognitive impairment, while another 19% exhibited symptoms of a possible anxiety disorder and 28% showed signs of major depressive disorder.

Study limitations include the use of clinical survey data, the retrospective nature of the research, and a lack of either a comparison group or pre-COVID-19 infection data.

“It is clear that in the wake of the COVID-19 pandemic, a second, longer term public health emergency has emerged,” authors concluded. “It is imperative to understand the burden of this novel condition with millions [of] Americans at risk of developing PACS by the end of the pandemic.”

References

1. Tabacof L, Tosto-Mancuso J, Wood J, et al. Post-acute COVID-19 syndrome negatively impacts physical function, cognitive function, health-related quat lity of life and participation. Am J Phys Med Rehbail. Published online October 20, 2021. doi: 10.1097/PHM.0000000000001910
2. Long COVID can negatively impact physical and cognitive function, employment, and quality of life for at least one year. News Release. EurekAlert; October 25, 2021. Accessed November 4, 2021. https://www.eurekalert.org/news-releases/932580.