Fatigue after COVID-19 disease associated with depression and anxiety in insured persons from healthcare and social professions

Background. Fatigue is one of the most frequent symptoms in post-COVID syndrome (PCS) patients and describes a long-term feeling of tiredness and exhaustion. Frequently, it follows an infection or is a component of depressive symptoms. But fatigue itself is also a risk to mental health like other chronic conditions. The objective of this paper was to analyse the relationship between fatigue and depression/anxiety and the differences between PCS patients and fully recovered COVID-19 cases. Methods. In a longitudinal study with three measurement points, insured members of the Statutory Accident Insurance and Prevention in the Health and Welfare Service with a SARS-CoV-2 infection in 2020 were asked about fatigue, depression/anxiety and persisting COVID-19 symptoms. To analyse the longitudinal effects of the two variables, a cross-lagged panel model was applied. Results. In the present sample (n = 860), a proportion of 68.7% to 75.1% of people was suffering from PCS. The results showed a model fit of R-2 = 61.49% and all effects were significant, but the cross-lagged effects were not significantly different from each other. If stratified according to whether PCS symptoms were present, the cross-lagged effects weakened in both groups, while the effects of fatigue on depression and anxiety only remained in the group of those affected by PCS. Discussion. The results show a relationship in both directions between fatigue and depression/anxiety. PCS patients can benefit from psychotherapeutic treatment to tackle fatigue and prevent depression and anxiety.