Technology Assisted Solutions for the Recognition of Objective Physiological Indicators of Post-Coronavirus-19 Fatigue
Condition: Covid19; Post Viral Fatigue
MeSH terms: Fatigue Syndrome, Chronic; Fatigue
Study type: Observational

Summary: 
      Preliminary research from our group indicates that up to half of COVID-19 patients are
      experiencing symptoms consistent with severe fatigue a median of 10 weeks after their initial
      illness, while almost one third of those previously employed have not returned to work. At
      present, most clinical and research measurements of fatigue have relied upon self-reported
      perception of sensations such as exhaustion or weariness. Using such tools, there is an
      inherent challenge for clinicians in differentiating between patients who are experiencing
      fatigue at a psychosocial level, versus those who are actively physiologically and
      neurocognitively deconditioned. The TROPIC study will use our existing clinical expertise and
      technology assisted solutions to address features of post-COVID-19 fatigue by quantifying
      physiological signatures of adverse sequelae in adult patients previously diagnosed with
      COVID-19, who are now COVID-19 negative. Our suite of assessments will encompass four
      systems; physical deconditioning, orthostatic instability, neurocognitive deficits and
      respiratory sequelae. This will not only inform accurate objective diagnostics of
      post-COVID-19 Chronic Fatigue Syndrome, but will also guide clinicians in directing the most
      appropriate therapeutic interventions with maximum efficacy and specificity, bringing not
      only patient-related but also health system and economic benefits.
    

Detailed description: 
      Background: At the time of writing, over 214 million people globally are infected with the
      Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It is estimated that up to 50%
      of people are experiencing debilitating levels of fatigue months after recovering from the
      acute phase of COVID-19, known as post COVID-19 Chronic Fatigue Syndrome (CFS). The most
      challenging aspect in the management of CFS for clinicians is the lack of objective
      measurement tools. At present, most clinical and research measurements of fatigue have relied
      upon self-reported perceptions of sensations such as exhaustion or weariness. We believe that
      an objective, technology-based assessment of this complex condition is required for the
      quantification of complex multi-system dynamic physiological signals in order to guide
      clinicians in directing targeted valuable resources towards therapeutic interventions with
      specificity and rigour to those patients who are most in need.

      Aim: The aim of the TROPIC study is to identify bio- signals and contributing factors in the
      development of post-Covid-19 Chronic Fatigue Syndrome using a suite of technology-assisted
      assessment techniques.

      TROPIC STUDY PARTICULARS:

      The primary endpoint will be successful recruitment and completion of data collection of 100
      participants in the TROPIC cohort.

      Setting: Assessments will take place in the Falls and Syncope Unit and Clinical Research
      Facility of St James's Hospital.

      Participants: Participants will be recruited from five sources; (i) the Robert Mayne Day
      Hospital, (ii) the Falls and Syncope Unit, (iii) Advocacy Groups, (iv) staff who contracted
      COVID-19, and (v) the Post COVID-19 outpatient (OPD) Clinic.

      Participants must be aged 18 years or older, have a history of COVID-19 and be free of
      exclusion criteria outlined in later sections.

      Data collection and analysis: Participants will be invited for one assessment session to St
      James's Hospital (SJH), where they will undergo a series of neurocardiovascular,
      neurocognitive and physical performance tests, outlined in more detail in later sections.
    

Observational model: Cohort
Time perspective: Cross-Sectional
Sampling method: Non-Probability Sample
Study population: 
        Adult participants over 18 years, with a history of COVID-19 who are community ambulant,
        mobilizing independently and free from contra-indications to testing procedures.
      
Keywords: fatigue; deconditioning; orthostatic intolerance; long-COVID