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Long-COVID fatigue is not predicted by pre-pandemic plasma IL-6 levels in mild COVID-19

Freidin, Maxim B. ; Cheetham, Nathan ; Duncan, Emma L. ; Steves, Claire J. ; Doores, Katherine J. ; Malim, Michael H. ; Rossi, Niccolo ; Lord, Janet M. ; Franks, Paul W. LU and Borsini, Alessandra , et al. (2023) In Inflammation Research 72(5). p.947-953
Abstract

Objective and design: Fatigue is a prominent symptom in the general population and may follow viral infection, including SARS-CoV2 infection which causes COVID-19. Chronic fatigue lasting more than three months is the major symptom of the post-COVID syndrome (known colloquially as long-COVID). The mechanisms underlying long-COVID fatigue are unknown. We hypothesized that the development of long-COVID chronic fatigue is driven by the pro-inflammatory immune status of an individual prior to COVID-19. Subjects and methods: We analyzed pre-pandemic plasma levels of IL-6, which plays a key role in persistent fatigue, in N = 1274 community dwelling adults from TwinsUK. Subsequent COVID-19-positive and -negative participants were categorized... (More)

Objective and design: Fatigue is a prominent symptom in the general population and may follow viral infection, including SARS-CoV2 infection which causes COVID-19. Chronic fatigue lasting more than three months is the major symptom of the post-COVID syndrome (known colloquially as long-COVID). The mechanisms underlying long-COVID fatigue are unknown. We hypothesized that the development of long-COVID chronic fatigue is driven by the pro-inflammatory immune status of an individual prior to COVID-19. Subjects and methods: We analyzed pre-pandemic plasma levels of IL-6, which plays a key role in persistent fatigue, in N = 1274 community dwelling adults from TwinsUK. Subsequent COVID-19-positive and -negative participants were categorized based on SARS-CoV-2 antigen and antibody testing. Chronic fatigue was assessed using the Chalder Fatigue Scale. Results: COVID-19-positive participants exhibited mild disease. Chronic fatigue was a prevalent symptom among this population and significantly higher in positive vs. negative participants (17% vs 11%, respectively; p = 0.001). The qualitative nature of chronic fatigue as determined by individual questionnaire responses was similar in positive and negative participants. Pre-pandemic plasma IL-6 levels were positively associated with chronic fatigue in negative, but not positive individuals. Raised BMI was associated with chronic fatigue in positive participants. Conclusions: Pre-existing increased IL-6 levels may contribute to chronic fatigue symptoms, but there was no increased risk in individuals with mild COVID-19 compared with uninfected individuals. Elevated BMI also increased the risk of chronic fatigue in mild COVID-19, consistent with previous reports.

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@article{f3618c0f-98c4-4e36-9b89-5d1175ffd33f,
  abstract     = {{<p>Objective and design: Fatigue is a prominent symptom in the general population and may follow viral infection, including SARS-CoV2 infection which causes COVID-19. Chronic fatigue lasting more than three months is the major symptom of the post-COVID syndrome (known colloquially as long-COVID). The mechanisms underlying long-COVID fatigue are unknown. We hypothesized that the development of long-COVID chronic fatigue is driven by the pro-inflammatory immune status of an individual prior to COVID-19. Subjects and methods: We analyzed pre-pandemic plasma levels of IL-6, which plays a key role in persistent fatigue, in N = 1274 community dwelling adults from TwinsUK. Subsequent COVID-19-positive and -negative participants were categorized based on SARS-CoV-2 antigen and antibody testing. Chronic fatigue was assessed using the Chalder Fatigue Scale. Results: COVID-19-positive participants exhibited mild disease. Chronic fatigue was a prevalent symptom among this population and significantly higher in positive vs. negative participants (17% vs 11%, respectively; p = 0.001). The qualitative nature of chronic fatigue as determined by individual questionnaire responses was similar in positive and negative participants. Pre-pandemic plasma IL-6 levels were positively associated with chronic fatigue in negative, but not positive individuals. Raised BMI was associated with chronic fatigue in positive participants. Conclusions: Pre-existing increased IL-6 levels may contribute to chronic fatigue symptoms, but there was no increased risk in individuals with mild COVID-19 compared with uninfected individuals. Elevated BMI also increased the risk of chronic fatigue in mild COVID-19, consistent with previous reports.</p>}},
  author       = {{Freidin, Maxim B. and Cheetham, Nathan and Duncan, Emma L. and Steves, Claire J. and Doores, Katherine J. and Malim, Michael H. and Rossi, Niccolo and Lord, Janet M. and Franks, Paul W. and Borsini, Alessandra and Granville Smith, Isabelle and Falchi, Mario and Pariante, Carmine and Williams, Frances M.K.}},
  issn         = {{1023-3830}},
  keywords     = {{BMI; Chronic fatigue; IL-6; Inflammation; Long-COVID}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{947--953}},
  publisher    = {{Birkhäuser}},
  series       = {{Inflammation Research}},
  title        = {{Long-COVID fatigue is not predicted by pre-pandemic plasma IL-6 levels in mild COVID-19}},
  url          = {{http://dx.doi.org/10.1007/s00011-023-01722-2}},
  doi          = {{10.1007/s00011-023-01722-2}},
  volume       = {{72}},
  year         = {{2023}},
}