Fatigue in children and young people up to 24 months after infection with SARS-CoV-2

Persistent fatigue is common following acute SARS-CoV-2 infection. Little is known about post-infection fatigue trajectories in children and young people (CYP). This paper reports on a longitudinal analysis of the Children and Young People with Long COVID study. SARS-CoV-2-positive participants, aged 11-to-17-years at enrolment, responding to follow-ups at 3-, 6-, 12-, and 24-months post-infection were included. Fatigue was assessed via the Chalder Fatigue Scale (CFQ; score range: 0-11, with ≥4 indicating clinical case-ness) and by a single-item (no, mild, severe fatigue). Fatigue was described cross-sectionally and examined longitudinally using linear mixed-effects models. Among 943 SARS-CoV-2-positive participants, 581 (61.6%) met CFQ case-ness at least once during follow-up. A higher proportion of ever-cases (vs. never-cases) were female (77.1% vs. 54.4%), older (mean age 15.0 vs. 13.9 years), and met Post-COVID Condition criteria 3-months post-infection (35.6% vs. 7.2%). The proportion of CFQ cases increased from 35.0% at 3-months to 40.2% at 24-months post-infection; 15.9% meet case-ness at all follow-ups. Single-item mild/severe responses showed sensitivity (≥0.728) and specificity (≥0.755) for CFQ case ascertainment. On average, CFQ scores increased by 0.448 points (95% CI, 0.252 to 0.645) over 24-months, but there were subgroup differences (e.g., fatigue increased faster in females than males and improved slightly in those meeting Post-COVID Condition criteria 3-months post-infection while worsening in those not meeting criteria). Persistent fatigue was prominent in CYP up to 24 months after infection. Subgroup differences in scores and trajectories highlight the need for targeted interventions. Single-item assessment is a practical tool for screening significant severe fatigue.

Authors

Institutions

Publication Details

Journal
Scientific Reports
Published
2025-11-20
DOI
https://doi.org/10.1038/s41598-025-24868-x
Primary Topic
Long-Term Effects of COVID-19
Type
article
Field-Weighted Citation Impact
0.00

Funders

Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
article

Fatigue in children and young people up to 24 months after infection with SARS-CoV-2

Esther Crawley, Terry Segal, Shruti Garg, Elizabeth Whittaker et al.
Scientific Reports
Long-Term Effects of COVID-19
article

Fatigue in children and young people up to 24 months after infection with SARS-CoV-2

Esther Crawley, Terry Segal, Shruti Garg, Elizabeth Whittaker, Isobel Heyman, Dougal Hargreaves, Ewan Carr, Olivia Swann, Snehal M. Pinto Pereira, Alvin Richards‐Belle, Marta Buszewicz, Shamez Ladhani, Vanessa Poustie, Trudie Chalder, Malcolm Gracie Semple, Natalia Rojas, Roz Shafran, Kelsey McOwat, Emma Dalrymple, Anthony Harnden, Kishan Sharma, Terence Stephenson, Bianca De Stavola, Michael Levin, Tamsin Ford, Ruth Simmons
article en

Abstract

Persistent fatigue is common following acute SARS-CoV-2 infection. Little is known about post-infection fatigue trajectories in children and young people (CYP). This paper reports on a longitudinal analysis of the Children and Young People with Long COVID study. SARS-CoV-2-positive participants, aged 11-to-17-years at enrolment, responding to follow-ups at 3-, 6-, 12-, and 24-months post-infection were included. Fatigue was assessed via the Chalder Fatigue Scale (CFQ; score range: 0-11, with ≥4 indicating clinical case-ness) and by a single-item (no, mild, severe fatigue). Fatigue was described cross-sectionally and examined longitudinally using linear mixed-effects models. Among 943 SARS-CoV-2-positive participants, 581 (61.6%) met CFQ case-ness at least once during follow-up. A higher proportion of ever-cases (vs. never-cases) were female (77.1% vs. 54.4%), older (mean age 15.0 vs. 13.9 years), and met Post-COVID Condition criteria 3-months post-infection (35.6% vs. 7.2%). The proportion of CFQ cases increased from 35.0% at 3-months to 40.2% at 24-months post-infection; 15.9% meet case-ness at all follow-ups. Single-item mild/severe responses showed sensitivity (≥0.728) and specificity (≥0.755) for CFQ case ascertainment. On average, CFQ scores increased by 0.448 points (95% CI, 0.252 to 0.645) over 24-months, but there were subgroup differences (e.g., fatigue increased faster in females than males and improved slightly in those meeting Post-COVID Condition criteria 3-months post-infection while worsening in those not meeting criteria). Persistent fatigue was prominent in CYP up to 24 months after infection. Subgroup differences in scores and trajectories highlight the need for targeted interventions. Single-item assessment is a practical tool for screening significant severe fatigue.

Scientific ReportsVol. 15(1)
University College London Hospitals NHS Foundation Trust (GB), University of Liverpool (GB), King's College London (GB), University of Cambridge (GB), Great Ormond Street Hospital (GB), University of Manchester (GB), Public Health England (GB), University of Bristol (GB), University of Oxford (GB), Manchester University NHS Foundation Trust (GB), Department of Science and Technology (IN), Institute of Child Health (GR), Cambridgeshire and Peterborough NHS Foundation Trust (GB), UK Health Security Agency (GB), University College London (GB), Imperial College London (GB), University of Edinburgh (GB)
UK Research and Innovation, National Institute for Health and Care Research, Department of Health and Social Care, NIHR Maudsley Biomedical Research Centre, Medical Research Council, Great Ormond Street Institute of Child Health
Openalex Percentile: Top 51%
Long-Term Effects of COVID-19
DOIOpen Access PDFOpenAlex
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.