Observational studyPhysical therapy2022
Chronic Fatigue and Postexertional Malaise in People Living With Long COVID: An Observational Study.
Observational study in Physical therapy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 141 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
141 citing papers in PubMed, 4 syntheses or guidelines pooled it, 290 citations in OpenAlex.
- Effectiveness and tolerance of exercise interventions for long COVID: a systematic review of randomised controlled trials.BMJ open · 2025Pooled it
- Evidence-based position paper on physical and rehabilitation medicine professional practice for persons with COVID-19, including post COVID-19 condition: the European PRM position (UEMS PRM Section).European journal of physical and rehabilitation medicine · 2023Guideline
- Evaluation of viral infection as an etiology of ME/CFS: a systematic review and meta-analysis.Journal of translational medicine · 2023Pooled it
- Clinical effectiveness of rehabilitation in ambulatory care for patients with persisting symptoms after COVID-19: a systematic review.BMC infectious diseases · 2023Pooled it
- Modulating subjective and objective cognitive state fatigue in long COVID with repetitive anodal tDCS: results from a double-blinded randomized controlled trial.BMC neuroscience · 2026Trial
- Exercise rehabilitation in post COVID-19 patients: a randomized controlled trial of different training modalities.European journal of physical and rehabilitation medicine · 2025Trial
- Effects of a symptom-titrated exercise program on fatigue and quality of life in people with post-COVID condition - a randomized controlled trial.Scientific reports · 2024Trial
- Personalised Health Behaviour Support Programme in Adults With Post-COVID Syndrome: A Randomised, Controlled Pilot Feasibility Trial.Health expectations : an international journal of public participation in health care and health policy · 2024Trial
- Exercise does not cause post-exertional malaise in Veterans with Gulf War Illness: A randomized, controlled, dose-response, crossover study.Brain, behavior, and immunity · 2024Trial
- Severity of activity limitation and prevalence of long COVID: a nationally representative cross-sectional study of adults in Scotland.Tropical medicine and health · 2026Article
- Bidirectional Associations Between Autonomic Function, Sleep Quality, and Daily Fatigue and Energy Symptoms in Long COVID: Longitudinal Digital Health Study.JMIR cardio · 2026Observational
- Characteristics Associated with Mental and Physical Health Among US Adults with Long COVID.Healthcare (Basel, Switzerland) · 2026Article
- Wearable Heart Rate Variability Monitoring, Autonomic Dysfunction and Post-exertional Malaise in Long COVID: An Observational Study.Sports medicine (Auckland, N.Z.) · 2026Article
- Commentary on: "Effect of inspiratory muscle training on inspiratory muscle strength in adults with post-COVID-19 condition and inspiratory muscle weakness: a randomized controlled trial".Journal of rehabilitation medicine · 2026Article
- Symptom, Functional, and Work Participation Profiles Among Racialized Canadians with Pre-Existing Mental Health Challenges and Long COVID: A Cross-Sectional Study.Healthcare (Basel, Switzerland) · 2026Article
- Patient and public involvement and engagement in Long COVID research: embedding inclusion in research.Research involvement and engagement · 2026Article
- Wearable- and Mobile App-Based Activity Pacing and Fatigue Management in Post-COVID-19 Condition: Exploratory Observational Study.JMIR formative research · 2026Observational
- Impact of post-exertional malaise frequency and fatigue in Long COVID patients on health-related quality of life.Health and quality of life outcomes · 2026Article
- Post-Exertional Malaise in Post-COVID-19 Syndrome: A Shift in the Frequency Across Pandemic Phases.Journal of clinical medicine · 2026Article
- Increased physical performance after personalised physiotherapy and nutritional counselling in adults with post-COVID-19 condition: a feasibility randomised trial.Communications medicine · 2026Article
81 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
objectivePeople living with long COVID describe a high symptom burden, and a more detailed assessment is needed to inform rehabilitation recommendations. The objectives were to use validated questionnaires to measure the severity of fatigue and compare this with normative data and thresholds for clinical relevance in other diseases; measure and describe the impact of postexertional malaise (PEM); and assess symptoms of dysfunctional breathing, self-reported physical activity, and health-related quality of life.
methodsThis was an observational study with a cross-sectional survey design (data collection from February 2021 to April 2021). Eligible participants were adults experiencing persistent symptoms due to COVID-19 that did not predate the confirmed or suspected infection. Questionnaires included the Functional Assessment of Chronic Illness Therapy-Fatigue Scale and the DePaul Symptom Questionnaire-Post-Exertional Malaise.
resultsAfter data cleaning, 213 participants were included in the analysis. The total Functional Assessment of Chronic Illness Therapy-Fatigue Scale score was 18 (SD = 10) (where the score can range from 0 to 52, and a lower score indicates more severe fatigue), and 71.4% were experiencing chronic fatigue. Postexertional symptom exacerbation affected most participants, and 58.7% met the PEM scoring thresholds used in people living with myalgic encephalomyelitis/chronic fatigue syndrome.
conclusionLong COVID is characterized by chronic fatigue that is clinically relevant and at least as severe as fatigue in several other clinical conditions. PEM is a significant challenge for this patient group. Because of the potential for setbacks and deteriorated function following overexertion, fatigue and postexertional symptom exacerbation must be monitored and reported in clinical practice and in studies involving interventions for people with long COVID. IMPACT: Physical therapists working with people with long COVID should measure and validate the patient's experience. Postexertional symptom exacerbation must be considered, and rehabilitation needs to be carefully designed based on individual presentation. Beneficial interventions might first ensure symptom stabilization via pacing, a self-management strategy for the activity that helps minimize postexertional malaise.
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Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.