ArticlePloS one2021
Fatigue following COVID-19 infection is not associated with autonomic dysfunction.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05532995 (Kinetics of Physiological and Symptomatic Responses to CardioPulmonary Exercise Testing), which is not on this map. Cited by 55 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Kinetics of Physiological and Symptomatic Responses to CardioPulmonary Exercise Testing (CPET) in Subjects With Persistent Exercise Intolerance After COVID-19: an Open-Source Exercise Network
Who cites it
55 citing papers in PubMed, 3 syntheses or guidelines pooled it, 93 citations in OpenAlex.
- Systematic Review of Dyspnea and Chronic Fatigue in Patients With Long COVID: Clinical Characteristics and Associated Laboratory Parameters.Pulmonary medicine · 2026Pooled it
- Post-COVID-19 fatigue: A systematic review.Frontiers in psychiatry · 2022Pooled it
- Psychiatric and neuropsychiatric sequelae of COVID-19 - A systematic review.Brain, behavior, and immunity · 2021Pooled it
- Transcutaneous Auricular Vagal Nerve Stimulation Against Fatigue Syndrome in Patients with Long COVID: Results of the Randomized, Placebo-Controlled Clinical Pilot Trial COVIVA.Neurology and therapy · 2026Article
- Autonomic dysfunction and quality of life in a cohort of neurology outpatients with post-acute sequelae of COVID-19, a two-year follow-up study.Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia · 2026Article
- Associations between multidimensional fatigue and wearable-derived cardio-respiratory variables in post-COVID-19 patients: an observational study.Frontiers in digital health · 2026Article
- Post-COVID-19 anxiety and its impact on adults' health in Qatar in 2022.Qatar medical journal · 2026Article
- Characterization of sympathicotonia in post-covid condition (long covid) and healthy controls using long-term electrodermal activity (EDA) follow-up.Clinical physiology and functional imaging · 2025Article
- Digitally Assessed Long COVID Symptomatology Is Associated With Lymphocyte Mitochondrial Dysfunction and Altered Immune Potential.Open forum infectious diseases · 2025Article
- The Use of Heart Rate Variability-Biofeedback (HRV-BF) as an Adjunctive Intervention in Chronic Fatigue Syndrome (CSF/ME) in Long COVID: Results of a Phase II Controlled Feasibility Trial.Journal of clinical medicine · 2025Article
- Article
- Internal medicine at the crossroads of long COVID diagnosis and management.Frontiers in medicine · 2025Review
- Bipolar spectrum, hypothyroidism, and their association with chronic fatigue/myalgic encephalomyelitis-like syndrome in long COVID: could they be identified as early determinants?Frontiers in psychiatry · 2025Article
- Defining and measuring long COVID fatigue: a scoping review.BMJ open · 2024Article
- Frontal-striatal glucose metabolism and fatigue in patients with multiple sclerosis, long COVID, and COVID-19 recovered controls.Experimental brain research · 2024Article
- Post-COVID dysautonomias: what we know and (mainly) what we don't know.Nature reviews. Neurology · 2024Review
- Fatigue and Mental Illness Symptoms in Long COVID: Protocol for a Prospective Cohort Multicenter Observational Study.JMIR research protocols · 2024Article
- Asymptomatic Autonomic Dysregulation after Recovery from Mild COVID-19 Infection Revealed by Analysis of Heart Rate Variability Responses to Task Load.Healthcare (Basel, Switzerland) · 2023Article
- A Review Article on Exercise Intolerance in Long COVID: Unmasking the Causes and Optimizing Treatment Strategies.Medical science monitor : international medical journal of experimental and clinical research · 2023Review
- The Relationship between Paresthesia and the Presence of Cardiac Dysautonomia in Patients with Post-COVID-19 Syndrome: A Preliminary Observational Study.Brain sciences · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundThe long-term clinical and physiological consequences of COVID-19 infection remain unclear. While fatigue has emerged as a common symptom following infection, little is known about its links with autonomic dysfunction. SARS-CoV-2 is known to infect endothelial cells in acute infection, resulting in autonomic dysfunction. Here we set out to test the hypothesis that this results in persistent autonomic dysfunction and is associated with post-COVID fatigue in convalescent patients.
methodsWe recruited 20 fatigued and 20 non-fatigued post-COVID patients (median age 44.5 years, 36/40 (90%) female, median time to follow up 166.5 days). Fatigue was assessed using the Chalder Fatigue Scale. These underwent the Ewing's autonomic function test battery, including deep breathing, active standing, Valsalva manoeuvre and cold-pressor testing, with continuous electrocardiogram and blood pressure monitoring, as well as near-infrared spectroscopy-based cerebral oxygenation. 24-hour ambulatory blood pressure monitoring was also conducted, and patients completed the generalised anxiety disorder-7 questionnaire. We assessed between-group differences in autonomic function test results and used unadjusted and adjusted linear regression to investigate the relationship between fatigue, anxiety, and autonomic test results.
resultsWe found no pathological differences between fatigued and non-fatigued patients on autonomic testing or on 24-hour blood pressure monitoring. Symptoms of orthostatic intolerance were reported by 70% of the fatigued cohort at the time of active standing, with no associated physiological abnormality detected. Fatigue was strongly associated with increased anxiety (p <0.001), with no patients having a pre-existing diagnosis of anxiety.
conclusionsThese results demonstrate the significant burden of fatigue, symptoms of autonomic dysfunction and anxiety in the aftermath of COVID-19 infection, but reassuringly do not demonstrate pathological findings on autonomic testing.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.