Long Covid fatigue can be worse than cancer and kidney disease

Many people with long Covid experience greater levels of illness and fatigue than those with cancer-related anaemia or severe kidney disease.

Research by scientists at University College London (UCL) and the University of Exeter found fatigue was the symptom with the greatest impact on the daily lives of people with long Covid. Many had fatigue scores worse than or similar to people with cancer-related anaemia or severe kidney disease, they found.

Health-related quality of life scores were also lower than those of people with advanced metastatic cancers, such as stage 4 lung cancer.

Overall, the impact of long Covid on the daily activities of patients was worse than that for stroke patients and comparable to people with Parkinson’s disease, the research, published in the journal BMJ Open, concluded.

The study also looked at the severity of breathlessness, anxiety, cognition (brain fog) and depression among long Covid patients.

Funded by the National Institute for Health and Care Research, the researchers looked at more than 3,750 patients who were referred to a long Covid clinic after experiencing symptoms for at least 12 weeks after infection.

Patients were asked to complete questionnaires on an app about how long Covid was affecting them, including its impact on their day-to-day activities and their levels of fatigue, depression, anxiety, breathlessness, brain fog, and their quality of life.

More than 90% were of working age (18-65). Worryingly, more than half (51%) said they had been unable to work for at least one day in the previous month, with 20% unable to work at all. Nearly three-quarters (71%) of the patients were female.

The researchers concluded: “Fatigue appears to be the symptom most strongly associated with functional impairment. Currently, clinical services lack evidence-based approaches in treating patients experiencing fatigue related to PCS [post-Covid-19 syndrome] with no standard rehabilitation pathway.”

Dr Henry Goodfellow, who co-led the study alongside the late Professor Elizabeth Murray (both from the UCL Institute of Epidemiology and Health Care), said: “Up to around 17% of people who get Covid go on to develop long Covid. However, the impact of the condition on patients’ day-to-day lives isn’t fully understood.

“Our results have found that long Covid can have a devastating effect on the lives of patients – with fatigue having the biggest impact on everything from social activities to work, chores and maintaining close relationships.”

According to the Office for National Statistics, around 1.4 million people in the UK had symptoms of long Covid as of July 2022. Alongside fatigue, patients typically experience breathlessness, anxiety, depression and brain fog.

Many employers have been finding that the input and expertise of occupational health practitioners has been critical in getting staff with long Covid back into work.

The latest study is believed to be the first to report on the impact of the condition on day-to-day functioning and health-related quality of life in patients who have been referred for specialist rehabilitation in long Covid clinics across England.

Dr Goodfellow said: “Our findings show that fatigue should be an important focus for clinical care and the design of rehabilitation services.

“Post-Covid assessment services should consider focusing on assessing and treating fatigue to maximise the recovery and return to work for sufferers of long Covid,” he added.