Key result
Post-COVID-19 condition linked to ~338% higher odds of post-exertional malaise and orthostatic intolerance.
Why the study?
Exercise-based treatments can exacerbate symptoms in people with post-COVID-19 condition who have post-exertional malaise or orthostatic intolerance, yet clinicians do not routinely assess these conditions.
Observational (n=3,783)
Odds Ratio: 4.38 (95% CI 3.01–6.38)
Absolute Event Rate: 48.1% vs 20.4%
p-value: p=<0.001
High proportions of post-exertional malaise and orthostatic intolerance in people with post-COVID-19 condition highlight the need for standard screening to avoid inappropriate exercise-based therapies.
May warrant caution with exercise prescriptions in post-COVID-19 condition; supports targeted symptom assessment but leaves optimal management open.
Background: Exercise-based treatments can worsen/exacerbate symptoms in people who were SARS-CoV-2 positive and living with post-COVID-19 condition (PL-PCC) and who have post-exertional malaise (PEM) or orthostatic intolerance (OI). Nevertheless, PEM and OI are not routinely assessed by clinicians. We estimated PEM and OI proportions in PL-PCC, as well as in people not living with PCC (PnL-PCC) and negatives (i.e., never reported a SARS-CoV-2 positive test), and identified associated factors. Methods: Participants from the Prevalence, Risk factors, and Impact Evaluation (PRIME) post-COVID-19 condition study were included. PEM and OI were assessed using validated questionnaires. PCC was defined as feeling unrecovered after SARS-CoV-2 infection. Multivariable regression analyses to study PEM and OI were stratified for sex. Results: Data from 3,783 participants were analyzed. In PL-PCC, the proportion of PEM was 48.1% and 41.2%, and the proportion of OI was 29.3% and 27.9% in women and men, respectively. Proportions were higher in PL-PCC than negatives, for PEM in women OR=4.38 [95%CI:3.01-6.38]; in men OR = 4.78 [95%CI:3.13-7.29]; for OI in women 3.06 [95%CI:1.97-4.76]; in men 2.71 [95%CI:1.75-4.21]. Associated factors were age ≤ 60 years, ≥1 comorbidities, and living alone. Conclusion: High proportions of PEM and OI are observed in PL-PCC. Standard screening for PEM and OI is recommended in PL-PCC to promote appropriate therapies.
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Pagen et al. (2023) conducted an observational in Post-COVID-19 condition (n=3,783). Post-COVID-19 condition vs. SARS-CoV-2 negatives was evaluated on Post-exertional malaise (PEM) in women (OR 4.38, 95% CI 3.01-6.38, p=<0.001). People living with post-COVID-19 condition had significantly higher odds of experiencing post-exertional malaise (OR 4.38 in women, 4.78 in men) and orthostatic intolerance compared to SARS-CoV-2 negatives.
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