Factors associated with post-exertional malaise in persons living with long COVID: A mixed-methods study

Post-COVID syndrome is a significant problem commonly encountered after contracting COVID-19 infection. Post-exertional malaise (PEM) is a particularly debilitating symptom of post-COVID syndrome. This mixed-method research aimed to study factors influencing the occurrence of PEM in post-COVID-19 patients. The sample group consisted of 98 post-COVID-19 patients receiving treatment at Phrachomklao Hospital, Phetchaburi province, Thailand were selected through simple random sampling. Data was collected through questionnaires and in-depth interviews. Data analysis involved descriptive statistics, multiple regression analysis, and content analysis. Results revealed that all members of sample group exhibited more than one post-COVID syndrome symptom. The most prevalent physical symptoms reported were fatigue (87.76%), exhaustion after activities (73.47%), and chronic cough (67.35%). Regarding mental, emotional, and social symptoms, the chief one reported was fear (74.49%), followed by stress (68.37%), and anxiety (53.06%). The overall assessment of post-exertional malaise in post-COVID patients revealed an average fatigue level of 4.09 (M = 4.09, SD = 0.78). Several factors together, including female sex, body mass index, and the severity of the COVID-19 illness, predicted presence of post-exertional malaise in post-COVID patients (R2 =0.441, p <0.05). Factors predicting PEM in post-COVID patients include female sex, body mass index, and the severity of COVID illness. These results increase our understanding of PEM in long COVID patients. Healthcare providers should develop service systems to provide post-fatigue care, especially for obese and severely ill COVID patients.