Thomas Bethan, Pattinson Rachael, Edwards Deborah, Dale Carys, Jenkins Benjamin, Lande Helena, Bundy Christine, Davies Jennifer
School of Healthcare Sciences, Cardiff University, Cardiff, UK
School of Dentistry, Cardiff University, Cardiff, UK.
BMJ Open. 2024 Dec 11;14(12):e088530. doi: 10.1136/bmjopen-2024-088530.
Long COVID encompasses a range of symptoms in which fatigue is one of the most prevalents. It is clear from other conditions that the definition and measurement of fatigue can be complex, but it is not clear how fatigue is defined and measured in long COVID. To advance our understanding, this review summarises the definitions and measures of long COVID fatigue being used by researchers.
Scoping review following JBI methodology and reports using the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping reviews.
Medline, Scopus, CINAHL, PsycINFO, EMCARE, Web of Science, Epistemonikos, Cochrane Central Register of Controlled Trials, Dimensions, Overton and ProQuest Dissertation & Theses Database were searched from January 2020 to May 2023.
This review included quantitative and qualitative studies that included any definition of long COVID and/or measurement tool that purported to quantify either the impact, severity or symptoms of long COVID fatigue.
Two independent reviewers screened the title, abstracts and full texts of the selected studies based on the inclusion criteria. Data extraction was performed by two independent reviewers. The data were summarised in tabular format and a narrative summary.
The search retrieved 9839 studies, of which 57 met the inclusion criteria. Only 21 (37%) provided a definition of fatigue. Definitions ranged across physical, mental, cognitive, emotional, psychosocial, central, peripheral, postexertional symptom exacerbation and general dimensions of fatigue. Fifty-five (96%) used a measurement or assessment of fatigue. Twenty-six measures of fatigue were identified: 21 self-report measures (eg, Fatigue Assessment Scale) and five fatigability measures that purport to reflect changes in physiological processes that contribute to or reflect fatigue (eg, change in force generating capacity of a muscle).
The definitions identified demonstrate considerable diversity, each highlighting different dimensions of long COVID fatigue. Long COVID fatigue was predominantly measured through self-report methods, which were problematic. There is an urgent need to better understand long COVID fatigue and to identify the different mechanisms involved. In order to do this, we need consistency with the language around fatigue and its measurement within research and across disciplines.
The protocol has been registered on open science framework (https://doi.org/10.17605/OSF.IO/HNF8Z).
长期新冠后遗症包含一系列症状，其中疲劳是最常见的症状之一。从其他病症中可以清楚地看出，疲劳的定义和测量可能很复杂，但目前尚不清楚长期新冠后遗症中的疲劳是如何定义和测量的。为了增进我们的理解，本综述总结了研究人员使用的长期新冠后遗症疲劳的定义和测量方法。
遵循JBI方法的范围综述，并使用系统评价和Meta分析扩展版的首选报告项目进行范围综述报告。
检索了2020年1月至2023年5月期间的Medline、Scopus、CINAHL、PsycINFO、EMCARE、Web of Science、Epistemonikos、Cochrane对照试验中央注册库、Dimensions、Overton以及ProQuest学位论文数据库。
本综述纳入了定量和定性研究，这些研究包括长期新冠后遗症的任何定义和/或旨在量化长期新冠后遗症疲劳的影响、严重程度或症状的测量工具。
两名独立评审员根据纳入标准筛选所选研究的标题、摘要和全文。数据提取由两名独立评审员进行。数据以表格形式和叙述性总结进行汇总。
检索到9839项研究，其中57项符合纳入标准。只有21项（37%）提供了疲劳的定义。定义范围涵盖身体、心理、认知、情感、心理社会、中枢、外周、运动后症状加重以及疲劳的一般维度。55项（96%）使用了疲劳的测量或评估方法。确定了26种疲劳测量方法：21种自我报告测量方法（如疲劳评估量表）和5种疲劳能力测量方法，这些方法旨在反映导致或反映疲劳的生理过程变化（如肌肉力量产生能力的变化）。
所确定的定义显示出相当大的多样性，每种定义都突出了长期新冠后遗症疲劳的不同维度。长期新冠后遗症疲劳主要通过自我报告方法进行测量，这存在问题。迫切需要更好地了解长期新冠后遗症疲劳，并确定其中涉及的不同机制。为了做到这一点，我们需要在研究和跨学科领域中，在疲劳及其测量的语言使用上保持一致。
该方案已在开放科学框架（https://doi.org/10.17605/OSF.IO/HNF8Z）上注册。
