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August 30, 2022
by Elizabeth Pratt

Long COVID Fatigue Linked To Depression and Anxiety

August 30, 2022 08:00 by Elizabeth Pratt  [About the Author]

Fatigue is associated with anxiety and depression in patients with long COVID. 

Research published in the Journal of Neurology found that fatigue was correlated with cognitive deficits as well as neuropsychiatric conditions, like depression.   

“(Fatigue) is impacting the quality of life of individuals who are suffering from this condition, so it is important to have more knowledge on its nature. Since it is known that fatigue may be related to cognitive disorders and neuropsychiatric symptoms, we focused on the study on these aspects in individuals with post-COVID-19,”  Marco Calabria, lead researcher of the article and a member of the Cognitive NeuroLab group at the UOC and a member of the Faculty of Health Sciences told Theravive. 

“We found that fatigue was negatively impacted the individuals’ quality of life and their everyday functionality, as we expected. Second, we found that the degree of fatigue was correlated with the presence of neuropsychiatric  symptoms such as depression, anxiety, and apathy. Additionally, there was a correlation with the presence of cognitive deficits such as sustained attention and executive functions. All these correlations were independent of the severity and whether individuals were hospitalized or not.” 

Those with long COVID can experience a variety of symptoms that can persist for weeks,  months and even years after their initial infection with COVID-19. 

Common symptoms of long COVID include fatigue that is so severe it interferes with daily life, fever and symptoms that may worsen after physical or mental activity (known as post-exertional malaise). 

Fatigue may present as excessive tiredness, cognitive weakness, physical weakness and muscular weakness. 

Recent research suggests that between 9 percent and 49 percent of patients experience fatigue at four weeks after onset of COVID symptoms. This may persist for a year in a third of patients. 

A study in Brain and Behavior found that COVID-19 could impact executive function, attention skills, long-term memory and learning. 

In undertaking the study in the Journal of Neurology, Calabria and colleagues examined a sample of 136 people with COVID-19 who were still experiencing cognitive deficits eight months after testing positive to COVID-19.

The patients underwent an assessment that included tests that measured their fatigue levels, executive functioning, apathy, quality of life and daily functioning. 

They were also assessed for depression and anxiety. 

82.3% percent of patients assessed showed significant levels of fatigue. They also reported worse quality of life and worse daily functioning when compared with those who didn’t report fatigue. 

23.5% of patients showed clinically significant levels of depression and 35.3% showed clinically significant levels of anxiety. 

“In our study, we found that fatigue was related to depression, anxiety, and apathy. Since it is a clinical condition that negatively impacts the quality of life, it is important to consider the role of this symptomatology in order to treat individuals with post-COVID-19,” Calabria said. 

He argues that now the link between depression and fatigue in long COVID has been established, further investigation should focus on how this could be applied to better improving therapeutic guidelines. 

“The clinical manifestations of post-COVID-19 is characterized by several persistent symptoms, and it is important to understand their nature. The understanding of this clinical conditions is necessary for clinicians who assess individuals with post-COVID-19, but also for patients. In this particular case, knowing that fatigue is related to other symptoms may help clinicians design tailed interventions,” he told Theravive.

“(Patients with long COVID) need a comprehensive assessment to objectively determine the nature of their disorders. The assessment should include a range of domains of cognition, neuropsychiatric symptoms, quality of life, among others. Second, if there is evidence of depression and anxiety, they should seek professional help to treat their condition.”

However, Calabria notes that further research to determine whether it is the fatigue that leads to depression, or whether it is depression leading to fatigue. 

Additional studies are also needed to better predict who might be impacted by long COVID. 

“We need to know what determines the risk of having persistent symptoms after infection to better predict them in individuals. Additionally, we should study the efficacy of rehabilitation programs that include also specific interventions for cognitive deficits and neuropsychiatric symptoms. We need a holistic approach to treat individuals with post-COVID-19,” he said. 

About the Author

Elizabeth Pratt

Elizabeth Pratt is a medical journalist and producer. Her work has appeared on Healthline, The Huffington Post, Fox News, The Australian Broadcasting Corporation, The Sydney Morning Herald,, Escape, The Cusp and Skyscanner. You can read more of her articles here. Or learn more about Elizabeth and contact her via her LinkedIn and Twitter profiles.

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