Neurophysiological characterisation of post-COVID fatigue

In most people, especially those under 40 years of age, a COVID infection typically produces only mild symptoms, without the need for hospitalisation. However it is becoming increasingly evident that, even after a mild infection, there can be neurological issues that can linger for much longer. Of these, fatigue and muscle weakness are reported very frequently (typically in 1 in 5 people) and can last for several weeks after recovery from the infection. As a new disease, how COVID impacts on brain function remains unclear and this is particularly true for post-COVID fatigue (pCF). We aim to study how pCF affects several different brain systems and to monitor their progression over time.

Fatigue can occur in many different conditions, but regardless of the cause, its detrimental impact on quality of life and productivity is well established, particularly if it develops into a chronic symptom. Even after this pandemic is brought under control, by whatever measures develop over the coming months and years, longer term issues such as fatigue will continue to reap a substantial cost both to the individuals but also to the economic recovery of the nation as a whole. By understanding the neural mechanisms of pCF we can understand the epidemiology better and make more rational decisions for interventions and treatments.

Despite the high severity of the SARS-CoV-2 virus in a substantial minority of those infected, most people only suffer from mild initial symptoms, which typically resolve without the need for hospitalisation. However there is increasing evidence that longer term neurological sequelae can occur even after mild disease, and of these, fatigue and muscle weakness are reported with a high incidence (typically >20%). Although fatigue can be a non-specific core symptom associated with many different conditions, its detrimental impact on quality of life and productivity is well established, particularly if it develops into a chronic symptom. As a novel disease, the mechanisms behind the impact of COVID on neural function remain unclear and this is particularly so for post-COVID fatigue (pCF). Our aim is to use observational and electrophysiological methods to characterise the neural mechanisms behind pCF, particularly with respect to the sensorimotor system and to monitor their progression over time. Even after this pandemic is brought under control, by whatever measures develop over the coming months and years, the longer term sequelae will continue to reap a substantial cost both to the individuals but also to the economic recovery of the nation as a whole. By understanding the neural mechanisms of pCF we can understand the epidemiology better and make more rational decisions for interventions and treatments.