High fatigue scores in patients with idiopathic inflammatory myopathies: a multigroup comparative study from the COVAD e-survey
Authors: Grignaschi Silvia , Kim Minchul , Zanframundo Giovanni , Ravichandran Naveen , Lilleker James B. , Sen Parikshit , Joshi Mrudula , Agarwal Vishwesh , Kardes Sinan , Day Jessica , Makol Ashima , Milchert Marcin , Gheita Tamer , Salim Babur , Velikova Tsvetelina , Gracia-Ramos Abraham Edgar , Parodis Ioannis , Nikiphorou Elena , Chatterjee Tulika , Tan Ai Lyn , Saavedra Miguel A. , Shinjo Samuel Katsuyuki , Ziade Nelly , Knitza Johannes , Kuwana Masataka , Nune Arvind , Distler Oliver , Chinoy Hector , Cavagna Lorenzo , Agarwal Vikas , Aggarwal Rohit , Gupta Latika ,   COVAD study group, Barman Bhupen , Singh Yogesh Preet , Ranjan Rajiv , Jain Avinash , Pandya Sapan C , Pilania Rakesh Kumar , Sharma Aman , Manoj M Manesh , Gupta Vikas , Kavadichanda Chengappa G , Patro Pradeepta Sekhar , Ajmani Sajal , Phatak Sanat , Goswami Rudra Prosad , Chowdhury Abhra Chandra , Mathew Ashish Jacob , Shenoy Padnamabha , Asranna Ajay , Bommakanti Keerthi Talari , Shukla Anuj , Pande Arunkumar R , Chandwar Kunal , Cansu Döndü Üsküdar , Pauling John D , Wincup Chris , Papa Nicoletta Del , Sambataro Gianluca , Fabiola Atzeni , Govoni Marcello , Parisi Simone , Bocci Elena Bartoloni , Sebastiani Gian Domenico , Fusaro Enrico , Sebastiani Marco , Quartuccio Luca , Franceschini Franco , Sainaghi Pier Paolo , Orsolini Giovanni , De Angelis Rossella , Danielli Maria Giovanna , Venerito Vincenzo , Traboco Lisa S , Wibowo Suryo Anggoro Kusumo , Serrano Jorge Rojas , Torre Ignacio García-De La , Tehozol Erick Adrian Zamora , Loarce-Martos Jesús , Prieto-González Sergio , Gonzalez Raquel Aranega , Yoshida Akira , Nakashima Ran , Sato Shinji , Kimura Naoki , Kaneko Yuko , Tomaras Stylianos , Gromova Margarita Aleksandrovna , Aharonov Or , Hmamouchi Ihsane , Hoff Leonardo Santos , Giannini Margherita , Maurier François , Campagne Julien , Meyer Alain , Nagy-Vincze Melinda , Langguth Daman , Limaye Vidya , Needham Merrilee , Srivastav Nilesh , Hudson Marie , Landon-Cardinal Océane , Shaharir Syahrul Sazliyana , Zuleta Wilmer Gerardo Rojas , Silva José António Pereira , Fonseca João Eurico 
Published: June 2023

Idiopathic inflammatory myopathies (IIMs) confer a significant risk of disability and poor quality of life, though fatigue, an important contributing factor, remains under-reported in these individuals. We aimed to compare and analyze differences in visual analog scale (VAS) scores (0–10 cm) for fatigue (VAS-F) in patients with IIMs, non-IIM systemic autoimmune diseases (SAIDs), and healthy controls (HCs). We performed a cross-sectional analysis of the data from the COVID-19 Vaccination in Autoimmune Diseases (COVAD) international patient self-reported e-survey. The COVAD survey was circulated from December 2020 to August 2021, and details including demographics, COVID-19 history, vaccination details, SAID details, global health, and functional status were collected from adult patients having received at least one COVID-19 vaccine dose. Fatigue experienced 1 week prior to survey completion was assessed using a single-item 10 cm VAS. Determinants of fatigue were analyzed in regression models. Six thousand nine hundred and eighty-eight respondents (mean age 43.8 years, 72% female; 55% White) were included in the analysis. The overall VAS-F score was 3 (IQR 1–6). Patients with IIMs had similar fatigue scores (5, IQR 3–7) to non-IIM SAIDs [5 (IQR 2–7)], but higher compared to HCs (2, IQR 1–5; P < 0.001), regardless of disease activity. In adjusted analysis, higher VAS-F scores were seen in females (reference female; coefficient −0.17; 95%CI −0.21 to −13; P < 0.001) and Caucasians (reference Caucasians; coefficient −0.22; 95%CI −0.30 to −0.14; P < 0.001 for Asians and coefficient −0.08; 95%CI −0.13 to 0.30; P = 0.003 for Hispanics) in our cohort. Our study found that patients with IIMs exhibit considerable fatigue, similar to other SAIDs and higher than healthy individuals. Women and Caucasians experience greater fatigue scores, allowing identification of stratified groups for optimized multidisciplinary care and improve outcomes such as quality of life.