Methodology:
This prospective cohort study was conducted among patients admitted at
COVID-19 wards at Dhaka Medical College Hospital between July and
August, 2020. During their hospital stay patients were evaluated for
complications such as fatigue, sleep disturbances, dyspnea etc. A total
of 373 patients were diagnosed to be suffering from some form of fatigue
using the validated bi-modal Chalder Fatigue Score, as described
previously (Townsend et al., 2020). We then approached patients
diagnosed as “fatigued” during hospital stay and asked them to
participate in a follow-up telephone interview regarding their disease
condition after two-months of their hospital discharge. All patients
agreed to participate in the interview and gave informed written
consent. Ethical permission was obtained from institutional review board
at Dhaka Medical College. After two months, patients were contacted over
phone. A total of 36 patients could not be reached even after repeated
attempts and five patients died during these two months. Hence, a total
of 332 patients participated in our study. Due to complexity associated
with conducting telephone interview and considering the socio-economic
background of most participants, they were asked to categorize their
fatigue symptoms into one of the following groups – “deteriorated,”
“same as acute phase infection,” “improved but persistent,” and
“completely recovered.” This approach of data collection and follow-up
of a heterogeneous group of COVID-19 patients through telephone
conversation was recorded in previous studies (Tenforde et al., 2020).
In addition to their responses, patient demographic data,
epidemiological, clinical and on- admission laboratory data (e.g. Hb%,
neutrophil, lymphocyte, C-reactive protein, d-dimer, and serum ferritin)
were obtained from hospital records. All the statistical analyses were
conducted using software package SPSS version 25. Categorical values
were presented as frequency and percentage. Continuous values were
presented as median and inter-quartile range (IQR). For the purpose of
statistical analysis, patients were either grouped as “fatigued” or
“not-fatigued” based on their responses. Wilcoxon Rank Sum Test and
Chi-square test were primarily used to test association between
variables. P-values less than 0.05 were considered significant for all
statistical testing.