Influence of Fatigue on Rehabilitation Trajectories of Post-COVID Patients: A Cohort Study

Rehabilitation is vital for post-COVID (PC) recovery, yet fatigue remains a persistent issue, and its impact on rehabilitation outcomes poorly understood. This study evaluates fatigue’s influence on PC patients’ Quality of Life (Qol) and physical performance (PP). A cohort of 193 PC patients (age 45±13, 74% female) underwent outpatient pulmonary rehabilitation in 2023. Fatigue Assessment Scale (FAS), PP as 6-Minute Walk Test (6MWT), and QoL (EQ5D-5L) were assessed at baseline and discharge. Effects were analyzed using Cohen’s d, correlations via Pearson correlation and fatigue-based rehabilitation trajectories were visualized. Patients showed substantial fatigue at admission (33.5±8.2) and discharge (31.1±8.9). All outcome measures improved significantly (p<.01). The largest effect was in 6MWT (d=.78), while FAS and QoL improved modestly (d>.19). At discharge, 81% still reported substantial or extreme fatigue. FAS changes negatively correlated with Qol and 6MWT (r<-.25, p<.001). 6MWT and Qol were uncorrelated (r=.06). Patients with extreme fatigue improved in PP but not in Qol (Fig. 1). <fig><object-id>erj;66/suppl_69/PA5799/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig> Rehabilitation effectively improves QoL and PP in PC patients. Fatigue significantly impacts PP and QoL, high fatigue limiting Qol gains. Patients with extreme fatigue have discordant rehabilitation trajectories, improving in PP but not QoL. Tailored rehabilitation programs addressing fatigue in PC patients are needed.