News Scan for Sep 19, 2022

High rates of fatigue, brain fog 9 months after nonsevere COVID-19

About 9 months after COVID-19 infection, 19% of nonhospitalized adult patients in a German cohort had fatigue, 26% had mild cognitive impairment (“brain fog”), and 1% had moderate cognitive dysfunction, according to a multicenter study.

The study, published late last week in EClinicalMedicinealso showed that the incidence and risk factors for fatigue and cognitive impairment differed by age-group.

The researchers administered the FACIT-Fatigue scale and Montreal Cognitive Assessment to 969 participants who had tested positive for COVID-19 at least 6 months earlier at three German hospitals from Nov 15, 2020, to Sep 29, 2021. A total of 55% of patients were women. The patients’ results were compared with those of 969 matched controls from a prepandemic, population-wide survey.

A median of 9 months after COVID-19 infection, 19% had clinically relevant fatigue, compared with 8% of controls. Risk factors included female sex, younger age, history of depression, and altered consciousness, dizziness, and muscle pain—but not illness severity—during acute infection. “This suggests that the affected organ systems, especially central and peripheral nervous system involvement, are more relevant for the development of fatigue than overall illness severity,” the authors wrote.

A total of 26% of patients had mild cognitive impairment—roughly twice the expected proportion—and 1% had moderate dysfunction. Risk factors for impaired cognition included older age, male sex, lower educational attainment, and a history of neuropsychiatric disease.

The link between fatigue and cognitive impairment was insignificant, and only 5% of patients had both conditions, while 14% had only fatigue, and 22% had only cognitive dysfunction. While fatigue tended to improve with time, the onset of cognitive impairment appeared to be delayed for several months.

“Fatigue and cognitive impairment are two common, but distinct sequelae of COVID-19 with potentially separate pathophysiological pathways,” the researchers wrote.

The team added that these persistent conditions may place a considerable burden on the health system. “Patients with post-COVID fatigue will require professional help, eg through specialized interdisciplinary outpatient clinics and rehabilitation programs,” they wrote.
Sep 17 EClinicalMedicine study

Diabetics’ excess weight, not blood sugar, tied to COVID-19, long COVID

Adults with diabetes and a high body mass index (BMI), not high blood sugar levels, are at greater risks of COVID-19 infection and long COVID, according to a meta-analysis involving more than 30,000 UK adults from nine cohort studies presented at the European Association for the Study of Diabetes (EASD) Annual Meeting taking place this week in Stockholm, Sweden.

“Our early findings support the idea that obesity-related mechanisms may be responsible for the excess risks of COVID-19 associated with diabetes, rather than high blood sugar per se,” said Anika Knuppel, PhD, a lead researcher on the study from the University College London, in an EASD news release.

To conduct the study, researchers combed nine major studies from the United Kingdom to look at self-reported COVID-19 infections and long COVID among adults and associations with HbA1c levels (average blood sugar level), self-reported or medication-based diabetes, BMI, and waist-to-hip ratio.

The 31,252 participants were aged 19 to 75 years old, and 57% were women.

The researchers found that people whose BMIs in the overweight (25 TO 29.9 kg/mtwo) or obese (30 kg/mtwo or greater) category had 10% and 16% greater odds of COVID-19 infection, respectively, compared to healthy weight individuals. For long COVID, the association was even greater, with overweight people having 20% ​​greater odds, and obese people having 36% greater odds.

Average blood sugar level and diabetes status revealed no association with COVID-19 or long COVID.
Sep 16 EASD
press release

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