Fatigue, cognitive complaints, dyspnea, anxiety, and depression as post-COVID syndrome: a cross-sectional study in Sfax, Southern Tunisia

TL;DR

This study in Tunisia found that many people who recovered from COVID-19 still experience symptoms like fatigue, brain fog, shortness of breath, anxiety, and depression, which significantly impact their daily lives.

Contribution

The study provides new insights into the prevalence and associations of specific post-COVID symptoms in a Southern Tunisian population.

Findings

88% of participants experienced fatigue, and it was strongly associated with cognitive complaints.

Anxiety and depression were significantly linked to cognitive complaints in post-COVID patients.

Older age (70-95 years) was most associated with very severe dyspnea after COVID-19.

Abstract

post-COVID refers to symptoms and health problems that continue or develop after the initial phase of a COVID-19 infection has resolved. It represents a huge public health issue, leading to considerable illness and lowering the quality of life for those affected. Our study aimed first to provide a general description of post-COVID conditions and then to examine the specific aspects of fatigue, cognitive complaints, dyspnea, anxiety, and depression in patients followed up in the pulmonology department of CHU Hedi Chaker, Sfax.

we conducted a cross-sectional study in the pulmonology department of CHU Hedi Chaker, Sfax in 2024 using an anonymous self-questionnaire with 4 validated scales to assess cognitive complaint, fatigue, dyspnea, as well as anxiety, and depression.

overall, 75 participants were included, with a sex ratio of 0.63 and a median age of 45 years (interquartile range (IQR= [35-66 years]). The evaluation of the impact of COVID-19 symptoms on daily life showed that 45.3% of the participants (n= 34) reported that fatigue had a severe impact on daily life, while 33.3% (n= 25) reported severe impacts from stress and negative emotions. The prevalences of fatigue, cognitive complaints, very severe dyspnea, anxiety, and depression based on the scale used were 88% (n= 66), 80% (n= 60), 14.7% (n= 11), 44% (n= 33) and 28.6% (n= 21), respectively. The factor most associated with fatigue in the population was cognitive complaints (OR= 25.3, p<0.001), while the factor most associated with dyspnea was age between 70 and 95 (OR= 12.85; p= 0.006). Furthermore, the factor most significantly associated with cognitive complaints was anxiety with an OR of 25.3 and p<0.001. As for anxiety and depression, the most associated factors were cognitive complaints and depression (OR=25.3; p<0.001) vs (OR= 27.1; p<0.001), respectively.

our study shows significant prevalences of post-COVID symptoms, such as fatigue, cognitive complaints, severe dyspnea, anxiety, and depression. Thus, post-COVID syndrome poses a significant public health challenge due to its wide array of symptoms that continue to affect individuals' health.

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