Fatigue and cognitive dysfunction in previously hospitalized patients with COVID-19: A 1-year follow-up

PLoS One. 2024 Nov 25;19(11):e0314131. doi: 10.1371/journal.pone.0314131. eCollection 2024.

Abstract

Purpose: The aim was to longitudinally explore changes in fatigue- and cognition-related symptoms during the first year after hospital treatment for COVID-19.

Method: Patients hospitalized for COVID-19 in Gothenburg, Sweden, were consecutively included from 01-07-2020 to 28-02-2021. Patients were assessed at the hospital (acute) and at 3 and 12 months after hospital discharge. Cognition was assessed with the Montreal Cognitive Assessment (MoCA), the Trail Making Test B (TMTB), and the Cognitive Failure Questionnaire (CFQ). Fatigue was assessed using the Multidimensional Fatigue Inventory-20 (MFI-20) and the Mental Fatigue Scale (MFS). Data was analyzed with demographics and changes over time calculated with univariable mixed-effects models.

Result: In total, 122 participants were included. Analyzes of Z-scores for MoCA indicated improvement over the year, however the results were 1 SD below norm at all assessments. Alertness (TMTB scores) improved significantly from the acute assessment to the 12- month follow-up (p = <0.001, 95% CI 34.67-69.67). CFQ scores indicated cognitive impairment, and the sum scores for MFI reflected a relatively high degree of fatigue at follow-up.

Conclusion: In the first year after hospitalization for COVID-19, most patients experienced fatigue and cognitive impairment. Alertness improved, but improvements in other domains were limited.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • COVID-19* / complications
  • COVID-19* / epidemiology
  • COVID-19* / psychology
  • Cognition
  • Cognitive Dysfunction*
  • Fatigue*
  • Female
  • Follow-Up Studies
  • Hospitalization*
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • SARS-CoV-2* / isolation & purification
  • Surveys and Questionnaires
  • Sweden / epidemiology

Grants and funding

This study was funded in part by the Swedish government under an agreement between the Swedish government and the county councils (ALFGBG-965653, ALFGBG-942914), Forte/Formas (2020-02775), Västragötaland regional research funding (VGFOUREG-969261, VGFOUREG-940508, VGFOUREG-969267), Västragötaland local research funding (VGFOUGSB-977360), and the Sahlgrenska University Hospital research funds (SU-961051). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.