Among the many symptoms, including myalgia (muscle pain), headache, cough and breathlessness, fatigue is most prevalent and makes a COVID-19 affected person severely debilitated.
A recent study, jointly done by Fortis and All India Institute of Medical Sciences, Delhi, and published in journal Diabetes and Metabolic Syndrome: Clinical Research and Reviews, indicated that type 2 diabetes (T2D) patients who had COVID-19 show significantly more fatigue and a more complicated course of COVID-19, resulting in excess morbidity and mortality. Further, diabetes posed challenges in recovery.
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“Post-COVID-19 syndrome [PCS] or Long COVID has emerged as a major roadblock in the recovery of patients infected with SARS-CoV-2,’’ said Dr. Anoop Misra, one of the authors of the study and executive chairman, Fortis Center of Excellence for Diabetes, Metabolic Diseases and Endocrinology. Presence of diabetes also influenced PCS via various pathophysiological mechanisms, he noted.
The study worked with a sample size of 108 type-2 diabetes patients and the methodology followed was to assess patients with T2D who came to the OPD at Fortis Hospital. The patients studied included 52 type 2 patients who had suffered from COVID-19 with mild to moderate severity and 56 type 2 diabetes patients who did not suffer from COVID-19.
The key findings included that T2D patients who had COVID-19 showed significantly more fatigue, and overall high fatigue seems to result from severe COVID-19 and high blood sugar levels. Rehabilitation of those with higher fatigue scores after acute infection would require careful attention to nutrition, glycemic control and graduated physical activity protocol. The authors concluded that these findings were particularly relevant in view of the increased prevalence of severe diabetes during times of COVID-19.
A debilitating factor
Dr. Misra observed that fatigue was a predominant and very debilitating factor, present afterwards in both hospitalised and non-hospitalised COVID-19 patients. Fatigue and associated symptoms decreased the quality of life and interfered with normal working capacity.
“This new important study re-emphasises that management of diabetes should be sustained and more stringent during a pandemic. COVID-19 fatigue should be addressed through a multidisciplinary approach, which includes the treating clinician, psychological counsellor, nutritionist, and physical therapy expert. Blood glucose and blood pressure should be optimal and more aggressive glycemic management is required. 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 COVID-19 as it may benefit not only fatigue but cardiovascular and pulmonary health and mental well-being of the patient,” he stated.
Centres that participated in the study included Fortis C-DOC Center of Excellence for Diabetes, Metabolic Diseases and Endocrinology; Centre of Nutrition and Metabolic Research (C-NET); National Diabetes, Obesity and Cholesterol Foundation(N-DOC); and the Department of Pulmonary, Critical Care and Sleep Medicine, AIIMS.
