Defining and measuring long COVID fatigue: a scoping review.

Publication date: Dec 11, 2024

Long COVID encompasses a range of symptoms in which fatigue is one of the most prevalents. It is clear from other conditions that the definition and measurement of fatigue can be complex, but it is not clear how fatigue is defined and measured in long COVID. To advance our understanding, this review summarises the definitions and measures of long COVID fatigue being used by researchers. Scoping review following JBI methodology and reports using the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping reviews. Medline, Scopus, CINAHL, PsycINFO, EMCARE, Web of Science, Epistemonikos, Cochrane Central Register of Controlled Trials, Dimensions, Overton and ProQuest Dissertation & Theses Database were searched from January 2020 to May 2023. This review included quantitative and qualitative studies that included any definition of long COVID and/or measurement tool that purported to quantify either the impact, severity or symptoms of long COVID fatigue. Two independent reviewers screened the title, abstracts and full texts of the selected studies based on the inclusion criteria. Data extraction was performed by two independent reviewers. The data were summarised in tabular format and a narrative summary. The search retrieved 9839 studies, of which 57 met the inclusion criteria. Only 21 (37%) provided a definition of fatigue. Definitions ranged across physical, mental, cognitive, emotional, psychosocial, central, peripheral, postexertional symptom exacerbation and general dimensions of fatigue. Fifty-five (96%) used a measurement or assessment of fatigue. Twenty-six measures of fatigue were identified: 21 self-report measures (eg, Fatigue Assessment Scale) and five fatigability measures that purport to reflect changes in physiological processes that contribute to or reflect fatigue (eg, change in force generating capacity of a muscle). The definitions identified demonstrate considerable diversity, each highlighting different dimensions of long COVID fatigue. Long COVID fatigue was predominantly measured through self-report methods, which were problematic. There is an urgent need to better understand long COVID fatigue and to identify the different mechanisms involved. In order to do this, we need consistency with the language around fatigue and its measurement within research and across disciplines. The protocol has been registered on open science framework (https://doi. org/10. 17605/OSF. IO/HNF8Z).

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Concepts Keywords
Medline COVID-19
Psychosocial COVID-19
Quantitative Fatigue
Humans
Post-Acute COVID-19 Syndrome
Public health
Research Design
SARS-CoV-2

Semantics

Type Source Name
disease MESH long COVID
drug DRUGBANK Methionine
disease MESH symptom exacerbation
drug DRUGBANK Tropicamide
disease MESH infection
disease IDO symptom
drug DRUGBANK Coenzyme M
disease IDO intervention
disease MESH Uncertainty
disease MESH depressive symptoms
disease MESH burnout
disease MESH Brain fog
disease IDO process
pathway KEGG Circadian rhythm
disease MESH viral infection
disease MESH bacterial infection
disease MESH anxiety
disease MESH insomnia
disease MESH parainfluenza
disease MESH syndrome
disease MESH sleepiness
disease IDO quality
disease MESH muscle fatigue
disease MESH Emotional fatigue
disease MESH emotional distress
disease MESH chronic diseases
disease MESH neuromuscular junction disorders
disease MESH central nervous system disorders
disease MESH Symptom Burden
pathway REACTOME Muscle contraction
pathway REACTOME Translation
disease MESH covid 19
disease MESH Multiple Sclerosis
disease MESH abnormalities
disease MESH sequelae
drug DRUGBANK Oxygen
disease MESH Myopathy
drug DRUGBANK Ubidecarenone
drug DRUGBANK Lipoic Acid
disease MESH functional status
disease MESH Breathlessness
pathway REACTOME Metabolism
drug DRUGBANK L-Arginine
disease MESH cognitive dysfunction
disease MESH sepsis
disease MESH fibromyalgia
disease MESH chronic fatigue syndrome
drug DRUGBANK Isoxaflutole
drug DRUGBANK Pentaerythritol tetranitrate
disease MESH affective symptoms
disease MESH oxidative damage
disease MESH inflammation
drug DRUGBANK Ozone
disease MESH Arthritis

Original Article

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