Prevalence and factors associated with severe fatigue two years after the start of the COVID-19 pandemic: a population-based cross-sectional study in Geneva, Switzerland

Clément Romain Hugo Graindorge, Stephanie Schrempft, Nick Pullen, Hélène Baysson, María-Eugenia Zaballa, Silvia Stringhini, Mayssam Nehme, Idris Guessous for the Specchio-COVID19 study group.
Prevalence and factors associated with severe fatigue 2 years into the COVID-19 pandemic: a cross-sectional population-based study in Geneva, Switzerland.BMJ Open, January 2025, doi: 10.1136/bmjopen-2024-08901

Abstract

Objectives: The aim of this study was to assess the prevalence of severe fatigue in the general population of Geneva, two years into the COVID-19 pandemic, and to identify factors associated with severe fatigue, whether related to the pandemic or not.

Design: Cross-sectional survey of the general population to be conducted in spring 2022.

Study setting: General adult population of Geneva, Switzerland. A total of 6870 adults, included in the Specchio-COVID-19 cohort on the basis of random selection from the general population, were invited to complete an online health questionnaire.

Outcome measures and associated factors: The prevalence of severe fatigue was assessed using the Chalder fatigue questionnaire, with a cut-off score ≥4 out of 11. Prevalence ratios were analysed in relation to socio-demographic factors, health characteristics and behaviours (body mass index, depression, recent diagnosis of chronic disease or allergy, acute health event, smoking status, physical activity, sleep quality) as well as recent self-reported COVID-19 infections.

Results: A total of 4040 people took part in the study (participation rate: 59%, 58% women, mean age: 53.2 years (standard deviation = 14.1)). The overall prevalence of severe fatigue was 30.7% (95% CI = 29.2%-32.1%). After adjustment for age, gender, education and pre-existing co-morbidities, the following characteristics were associated with severe fatigue:

Age 18-24 years (adjusted prevalence ratio (APR) = 1.39 (1.10-1.76)) and 25-34 years (APR = 1.23 (1.05-1.45))

-Female (AOR = 1.28 (1.16-1.41))

-Depression (RPa = 2.78 (2.56-3.01))

-Occurrence of health events unrelated to COVID-19 (RPa = 1.51 (1.38-1.65))

-Self-reported COVID-19 infection in the last 12 months (RPa = 1.41 (1.28-1.56)).

After further adjustment for depression, the previous associations were maintained, except for young age.

Conclusions: Approximately one third of the general adult population of Geneva suffered from severe fatigue two years after the onset of the COVID-19 pandemic. The increased fatigue in young adults is partly explained by depressive symptoms. Recent infections with COVID-19 are strongly associated with severe fatigue, regardless of the severity of the infection or the simultaneous presence of depressive disorders.

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