Risk factors for fatigue severity in the post-COVID-19 condition: A prospective controlled cohort study of nonhospitalised adolescents and young adults

Long COVID is a global health concern, leading to persistent symptoms and disability long after the acute SARS-CoV-2 infection in most age groups. The condition can manifest even following mild COVID-19, and in young people, it may have serious adverse consequences for educational attainment and tra...

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Main Authors: Joel Selvakumar, Lise Beier Havdal, Elias Myrstad Brodwall, Silke Sommen, Lise Lund Berven, Tonje Stiansen-Sonerud, Erin Cvejic, Vegard Bruun Bratholm Wyller
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:Brain, Behavior, & Immunity - Health
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666354625000250
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author Joel Selvakumar
Lise Beier Havdal
Elias Myrstad Brodwall
Silke Sommen
Lise Lund Berven
Tonje Stiansen-Sonerud
Erin Cvejic
Vegard Bruun Bratholm Wyller
author_facet Joel Selvakumar
Lise Beier Havdal
Elias Myrstad Brodwall
Silke Sommen
Lise Lund Berven
Tonje Stiansen-Sonerud
Erin Cvejic
Vegard Bruun Bratholm Wyller
author_sort Joel Selvakumar
collection DOAJ
description Long COVID is a global health concern, leading to persistent symptoms and disability long after the acute SARS-CoV-2 infection in most age groups. The condition can manifest even following mild COVID-19, and in young people, it may have serious adverse consequences for educational attainment and transition to adulthood. Fatigue is the most prevalent symptom, but the underlying mechanisms remain poorly understood. In this prospective study of 404 SARS-CoV-2-positive and 105 SARS-CoV-2 negative, non-hospitalised youth (ages 12–25, female 62%), we investigated which factors in the early convalescent stage (<28 days since test) were associated with the severity of persistent fatigue at 6 months after infection. Participants completed questionnaires regarding clinical symptoms, social factors and psychological traits, and were subject to clinical and functional testing and biomarker analyses. Variables with significant (p < 0.2) associations to the outcome in simple linear regression were chosen for multivariable modelling, together with potential confounders. In the final multivariable model, SARS-CoV-2-positivity was a minor risk factor for fatigue severity at six months. Baseline severity of symptoms was the main risk factor and correlated with psychosocial factors such as loneliness and neuroticism, rather than biomarkers. Our results suggest that factors not related to infection are major risk factors for persistent fatigue in this age group.
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spelling doaj-art-76d898d40e6e4e4fbbaad006c9f997232025-08-20T02:05:13ZengElsevierBrain, Behavior, & Immunity - Health2666-35462025-03-014410096710.1016/j.bbih.2025.100967Risk factors for fatigue severity in the post-COVID-19 condition: A prospective controlled cohort study of nonhospitalised adolescents and young adultsJoel Selvakumar0Lise Beier Havdal1Elias Myrstad Brodwall2Silke Sommen3Lise Lund Berven4Tonje Stiansen-Sonerud5Erin Cvejic6Vegard Bruun Bratholm Wyller7Department of Paediatrics and Adolescent Health, Akershus University Hospital, PO Box 1000, Lørenskog, N-1478, Norway; Institute of Clinical Medicine, University of Oslo, PO Box 1171, Blindern, N-0318, Oslo, Norway; Corresponding author. Dept. of Paediatrics, Akershus University Hospital, Lørenskog, N-1478, Norway.Department of Paediatrics and Adolescent Health, Akershus University Hospital, PO Box 1000, Lørenskog, N-1478, NorwayDepartment of Paediatrics and Adolescent Health, Akershus University Hospital, PO Box 1000, Lørenskog, N-1478, NorwayDepartment of Paediatrics and Adolescent Health, Akershus University Hospital, PO Box 1000, Lørenskog, N-1478, Norway; University of Oslo, Oslo, NorwayDepartment of Paediatrics and Adolescent Health, Akershus University Hospital, PO Box 1000, Lørenskog, N-1478, NorwayDepartment of Paediatrics and Adolescent Health, Akershus University Hospital, PO Box 1000, Lørenskog, N-1478, Norway; Department of Clinical Molecular Biology (EpiGen), University of Oslo and Akershus University Hospital, PO Box 1000, Lørenskog, N-1478, NorwayThe University of Sydney, School of Public Health, Faculty of Medicine and Health, Edward Ford Building (A27) Fisher Road, NSW, 2006, AustraliaDepartment of Paediatrics and Adolescent Health, Akershus University Hospital, PO Box 1000, Lørenskog, N-1478, Norway; Institute of Clinical Medicine, University of Oslo, PO Box 1171, Blindern, N-0318, Oslo, NorwayLong COVID is a global health concern, leading to persistent symptoms and disability long after the acute SARS-CoV-2 infection in most age groups. The condition can manifest even following mild COVID-19, and in young people, it may have serious adverse consequences for educational attainment and transition to adulthood. Fatigue is the most prevalent symptom, but the underlying mechanisms remain poorly understood. In this prospective study of 404 SARS-CoV-2-positive and 105 SARS-CoV-2 negative, non-hospitalised youth (ages 12–25, female 62%), we investigated which factors in the early convalescent stage (<28 days since test) were associated with the severity of persistent fatigue at 6 months after infection. Participants completed questionnaires regarding clinical symptoms, social factors and psychological traits, and were subject to clinical and functional testing and biomarker analyses. Variables with significant (p < 0.2) associations to the outcome in simple linear regression were chosen for multivariable modelling, together with potential confounders. In the final multivariable model, SARS-CoV-2-positivity was a minor risk factor for fatigue severity at six months. Baseline severity of symptoms was the main risk factor and correlated with psychosocial factors such as loneliness and neuroticism, rather than biomarkers. Our results suggest that factors not related to infection are major risk factors for persistent fatigue in this age group.http://www.sciencedirect.com/science/article/pii/S2666354625000250Long COVIDPost-COVID-19 conditionPost-acute sequelae of COVID-19AdolescentsSARS-CoV-2Post-infective fatigue syndrome
spellingShingle Joel Selvakumar
Lise Beier Havdal
Elias Myrstad Brodwall
Silke Sommen
Lise Lund Berven
Tonje Stiansen-Sonerud
Erin Cvejic
Vegard Bruun Bratholm Wyller
Risk factors for fatigue severity in the post-COVID-19 condition: A prospective controlled cohort study of nonhospitalised adolescents and young adults
Brain, Behavior, & Immunity - Health
Long COVID
Post-COVID-19 condition
Post-acute sequelae of COVID-19
Adolescents
SARS-CoV-2
Post-infective fatigue syndrome
title Risk factors for fatigue severity in the post-COVID-19 condition: A prospective controlled cohort study of nonhospitalised adolescents and young adults
title_full Risk factors for fatigue severity in the post-COVID-19 condition: A prospective controlled cohort study of nonhospitalised adolescents and young adults
title_fullStr Risk factors for fatigue severity in the post-COVID-19 condition: A prospective controlled cohort study of nonhospitalised adolescents and young adults
title_full_unstemmed Risk factors for fatigue severity in the post-COVID-19 condition: A prospective controlled cohort study of nonhospitalised adolescents and young adults
title_short Risk factors for fatigue severity in the post-COVID-19 condition: A prospective controlled cohort study of nonhospitalised adolescents and young adults
title_sort risk factors for fatigue severity in the post covid 19 condition a prospective controlled cohort study of nonhospitalised adolescents and young adults
topic Long COVID
Post-COVID-19 condition
Post-acute sequelae of COVID-19
Adolescents
SARS-CoV-2
Post-infective fatigue syndrome
url http://www.sciencedirect.com/science/article/pii/S2666354625000250
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