Post-Covid19 syndrome (PCS) or Long Covid has emerged as a major roadblock in the recovery of patients infected with SARS-CoV-2. Amidst many symptoms such as myalgia (muscle pain), headache, cough and breathlessness, fatigue is most prevalent and makes a Covid patient severely debilitated.
In a first-of-its-kind global study, done by Padma Shri Dr Anoop Misra, Executive Chairman and Director, Diabetes and Endocrinology, Fortis C-DOC, in association with Fortis C-DOC, AIIMS, C-NET, N-DOC and Diabetes Foundation reveals that Type 2 diabetes (T2D) patients who had Covid19 showed significantly more fatigue when compared with patients who did not have Covid19. It states that diabetes not only complicates the course of Covid19 but also results in excess morbidity and mortality. Further, diabetes also influences PCS via various pathophysiological mechanisms, and poses a challenge in the recovery. The study was published in the journal, Diabetes & Metabolic Syndrome: Clinical Research & Reviews.
Patients studied included 52 Type 2 Diabetes patients who had suffered from Covid19 with mild to moderate severity; 56 Type 2 Diabetes patients who did not suffer from Covid19. Both groups were matched for age, duration of diabetes, BMI, TSH, serum albumin and vitamin D levels.
“Fatigue is a predominant and very debilitating factor, present afterwards in both hospitalised and non-hospitalised Covid19 patients. Fatigue and associated symptoms decrease the quality of life and interfere with normal working capacity,” says Dr MIsra, adding that it is imperative for chronic diabetic patients to follow a healthy lifestyle, adhere to treatment guidelines and go for regular health checks.
This study re-emphasizes that diabetes management should be sustained and more stringent during a pandemic, and should be addressed through a multidisciplinary approach which includes the treating clinician, psychological counsellor, nutritionist, and physical therapy expert.
“Special care must be taken regarding nutrition and protein and vitamin supplements should be used as required. Exercise and physiotherapy should be started early after Covid19 as it may benefit not only fatigue but cardiovascular and pulmonary health and mental well-being of the patient,” he adds.
♦ T2D patients who had Covid19 showed significantly more fatigue when compared with patients who did not have Covid19 but both groups had comparable handgrip strength.
♦ T2D with previous Covid19 infection and who had Fatigue score > 4 have (high fatigue level) had significant higher inflammation markers during acute illness, and post Covid19, had increased post prandial blood glucose levels, lost more weight, had reduced physical activity and showed significantly lower handgrip strength as compared to those with Fatigue score < 4. Overall, high fatigue seems to result from severe COVID-19, and high blood sugar levels.
♦ Rehabilitation of those with fatigue score>4 after acute infection would require careful attention to nutrition, glycemic control and graduated physical activity protocol
♦ These findings are particularly relevant in view of increased prevalence of severe diabetes during times of Covid19.