Evidence map›Paper›PMID 37286327›Full record

Observational studyBMJ open2023

Impact of fatigue as the primary determinant of functional limitations among patients with post-COVID-19 syndrome: a cross-sectional observational study.

Sarah Walker, Henry Goodfellow, Patra Pookarnjanamorakot, Elizabeth Murray, Julia Bindman, Ann Blandford, Katherine Bradbury, Belinda Cooper, Fiona L Hamilton, John R Hurst and 11 more

Open access · goldAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 77 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
77citing papers in PubMed, 4 pooled it
23.9field-weighted citation impact, top 1% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

77 citing papers in PubMed, 4 syntheses or guidelines pooled it, 116 citations in OpenAlex.

  1. Pooled it
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  5. Trial
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  7. A digital intervention for cognitive deficits following COVID-19: a randomized clinical trial.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2024
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  14. Health economic outcomes and national economic impacts associated with Long COVID in England and Scotland.The European journal of health economics : HEPAC : health economics in prevention and care · 2026
    Article
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17 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors at 6 institutions in 1 country.

Sarah WalkerDepartment of Health and Community Sciences (Medical School), University of Exeter, Exeter, UK.ORCID 0000-0003-4201-1093
Henry GoodfellowDepartment of Primary Care and Population Health, University College London, London, UK.ORCID 0000-0002-0979-2839
Patra PookarnjanamorakotGeneral Medicine, Whittington Health NHS Trust, London, UK.
Elizabeth MurrayPrimary Care and Population Health, University College London, London, UK.ORCID 0000-0002-8932-3695
Julia BindmanResearch Department of Primary Care and Population Health, University College London, London, UK.
Ann BlandfordUCLIC, Department of Computer Science, University College London, London, UK.ORCID 0000-0002-3198-7122
Katherine BradburyPsychology, University of Southampton, Southampton, UK.
Belinda CooperResearch Department of Primary Care and Population Health, University College London, London, UK.
Fiona L HamiltonResearch Department of Primary Care and Population Health, University College London, London, UK.
John R HurstUCL Respiratory, University College London, London, UK.ORCID 0000-0002-7246-6040
Hannah HyltonDepartment of Respiratory Medicine, Barts Health NHS Trust, London, UK.
Stuart LinkeResearch Department of Primary Care and Population Health, University College London, London, UK.
Paul PfefferDepartment of Respiratory Medicine, Barts Health NHS Trust, London, UK.
William RickettsRespiratory Medicine, Barts Health NHS Trust, London, UK.ORCID 0000-0002-0475-0744
Chris Robson10 Queen Street Place, London, EC4R 1AG, Living With Ltd, London, UK.
Fiona A StevensonResearch Department of Primary Care and Population Health, University College London, London, UK.
David SunkersingResearch Department of Primary Care and Population Health, University College London, London, UK.
Jiunn WangDepartment of Applied Health Research, University College London, London, UK.
Manuel GomesDepartment of Applied Health Research, University College London, London, UK.
William HenleyDepartment of Health and Community Sciences (Medical School), University of Exeter, Exeter, UK w.e.henley@exeter.ac.uk.ORCID 0000-0001-6273-2619
Living With Covid Recovery CollaborationUniversity College London, London, UK.
University College London · GBBarts Health NHS Trust · GBUniversity of Exeter · GBLiving Streets · GBUniversity of Southampton · GBWhittington Health NHS Trust · GB

Funding

Department of Health NIHR132243
6 · The paper itself

Abstract

objectivesTo describe self-reported characteristics and symptoms of treatment-seeking patients with post-COVID-19 syndrome (PCS). To assess the impact of symptoms on health-related quality of life (HRQoL) and patients' ability to work and undertake activities of daily living.

designCross-sectional single-arm service evaluation of real-time user data.

setting31 post-COVID-19 clinics in the UK.

participants3754 adults diagnosed with PCS in primary or secondary care deemed suitable for rehabilitation.

interventionPatients using the Living With Covid Recovery digital health intervention registered between 30 November 2020 and 23 March 2022. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was the baseline Work and Social Adjustment Scale (WSAS). WSAS measures the functional limitations of the patient; scores of ≥20 indicate moderately severe limitations. Other symptoms explored included fatigue (Functional Assessment of Chronic Illness Therapy-Fatigue), depression (Patient Health Questionnaire-Eight Item Depression Scale), anxiety (Generalised Anxiety Disorder Scale, Seven-Item), breathlessness (Medical Research Council Dyspnoea Scale and Dyspnoea-12), cognitive impairment (Perceived Deficits Questionnaire, Five-Item Version) and HRQoL (EQ-5D). Symptoms and demographic characteristics associated with more severe functional limitations were identified using logistic regression analysis.

results3541 (94%) patients were of working age (18-65); mean age (SD) 48 (12) years; 1282 (71%) were female and 89% were white. 51% reported losing ≥1 days from work in the previous 4 weeks; 20% reported being unable to work at all. Mean WSAS score at baseline was 21 (SD 10) with 53% scoring ≥20. Factors associated with WSAS scores of ≥20 were high levels of fatigue, depression and cognitive impairment. Fatigue was found to be the main symptom contributing to a high WSAS score.

conclusionA high proportion of this PCS treatment-seeking population was of working age with over half reporting moderately severe or worse functional limitation. There were substantial impacts on ability to work and activities of daily living in people with PCS. Clinical care and rehabilitation should address the management of fatigue as the dominant symptom explaining variation in functionality.

Indexed as

COVID-19Quality of LifeActivities of Daily LivingAdolescentAdultAgedCross-Sectional StudiesFatigueFemaleHumansMaleMiddle AgedPost-Acute COVID-19 SyndromeYoung AdultAnxiety disordersCOVID-19Depression & mood disordersMENTAL HEALTHPRIMARY CAREPublic health

Identifiers

PMID37286327
PMCPMC10335413
OpenAlexW4379741377

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.