High prevalence of post COVID-19 fatigue in patients with type 2 diabetes: A case-control study

Abstract Background Post COVID-19 syndrome (PCS) has emerged as a major roadblock in the recovery of patients infected with SARS-CoV-2. Amongst many symptoms like myalgia, headache, cough, breathless; fatigue is one of the major symptoms which makes the patient severely debilitated. Research on PCS, in particular fatigue, in patients with diabetes has not been done. Methodology In this prospective study, we included patients with type 2 diabetes (T2D) who had COVID-19 infection (mild to moderate severity), and matched T2D patients who did not suffer from COVID-19 infection. Demography, anthropometry, glycemic measures, treatment, COVID-19 infection details were recorded. Symptoms were scored using Chalder Fatigue Scale (reported as fatigue score, FS) and handgrip strength (in kg) was recorded by Jamar Hydraulic Hand Dynamometer. Results A total of 108 patients were included (cases, 52, controls, 56). Both groups were matched for age, duration of diabetes, BMI, TSH and vitamin D levels. T2D patients with COVID-19 infection had significant more fatigue when compared with patients without COVID-19 infection but comparable handgrip strength. Furthermore, patients with T2D with previous COVID-19 infection and who had FS >4 have had significant higher inflammation markers during acute illness, and post COVID-19, had increased post prandial blood glucose levels, lost more weight, had reduced physical activity and significantly lower handgrip strength as compared to those with FS Conclusion Patients with T2D who had COVID-19 infection as compared to those without had significantly more fatigue after the acute illness, and those with higher fatigue score had reduced handgrip strength indicating sarcopenia. Rehabilitation of those with FS >4 after acute infection would require careful attention to nutrition, glycemic control and graduated physical activity protocol.