“Take it seriously, investigate the causes and provide information” - The current strategy for fatigue and long COVID
Long COVID, fatigue and chronic fatigue syndrome - the group of patients with these diagnoses is growing. Prof. Dr. Christian Dettmers from Constance is a specialist for Long COVID. He will speak at the CON.THERA therapists' congress.
“Fatigue is a serious problem for the affected patients. The tiredness and exhaustion, as well as the long recovery period, make life very difficult. In terms of treatment, the first step is always to look for organic causes and determine whether there are any cognitive impairments, or whether psychosocial components intensify the syndrome.”
While fatigue is a subjectively experienced tiredness, the term fatigability refers to a potential organic cause of low physical performance and weariness. This complex of symptoms can be triggered by rheumatic diseases or even cancer.
“We must always take the symptoms of fatigue seriously, even if we cannot determine any organic causes in this patient group”, emphasises Dettmers. He believes that there could be many psychosocial causes for the exhaustion following an infection, which is also triggered by media coverage: “If the condition is down to organic causes, as is the case with MS, it is easy to speak to patients about the cognitive and psychological symptoms, and choose a course of therapy together.
The situation is much more difficult if there is no organic cause, or in the case of long COVID. Here, it is hard to convince patients that the weariness they experience could be related to other factors aside from their previous COVID infection. This would make it easier to develop a way for them to deal with perceived crises and the accompanying tiredness.”
In a holistic socio-medical approach, differentiating between fatigue and fatigability allows doctors to consider both the subjective aspects and the objective findings. “When it comes to fatigue in MS patients, it is important to clarify to them that any early fatigability does not cause neurological damage. This stops the patients from developing preventative strategies and resting to avoid expected exhaustion”, says Prof. Dr Dettmers.