tetano
Editor, Senior Moderator
BMJ Open
. 2026 May 13;16(5):e116993.
doi: 10.1136/bmjopen-2026-116993.
Fatigue after COVID-19 in occupationally exposed workers: prevalence, severity and associated risk factors in a cross-sectional analysis of a multicentre registry study
Kerrin Kobes[SUP] 1 [/SUP], Corinna Rademacher[SUP] 2 [/SUP], Agnessa Kozak[SUP] 3 [/SUP], Andreas Gonschorek[SUP] 4 [/SUP], Ingo Schmehl[SUP] 5 [/SUP], Susann Seddigh[SUP] 6 [/SUP], Andrea Fürst[SUP] 7 [/SUP], Kai Wohlfarth[SUP] 8 9 [/SUP], Lynn Engel[SUP] 2 [/SUP], Jakob Wefers[SUP] 2 [/SUP], Jana Wischnat[SUP] 3 [/SUP], Olaf Kleinmüller[SUP] 10 [/SUP], Albert Nienhaus[SUP] 3 [/SUP], Martin Tegenthoff[SUP] 2 [/SUP], Peter Schwenkreis[SUP] 2 [/SUP]
Affiliations
Objectives: As fatigue is among the most frequent manifestations of post-COVID syndrome (PCS), this study aimed to assess the prevalence and severity of cognitive and physical fatigue after occupational SARS-CoV-2 infection and to identify sociodemographic, clinical and occupational predictors of fatigue severity.
Design: Cross-sectional analysis of a multicentre prospective registry.
Setting: Six German Social Accident Insurance hospitals distributed across Germany, providing standardised post-COVID assessments for individuals with persistent symptoms following occupational SARS-CoV-2 infection.
Participants: Workers with confirmed SARS-CoV-2 infection recognised as an occupational disease or work-related accident who presented with persistent symptoms and were enrolled in a multicentre post-COVID registry.
Primary and secondary outcome measures: Cognitive and physical fatigue severity assessed using validated self-administered questionnaires (Fatigue Scale for Motor and Cognitive Functions, Modified Fatigue Impact Scale and Würzburg Fatigue Inventory for Multiple Sclerosis). Clinical relevance was determined based on established cut-offs reported in the literature. Fatigue severity was operationalised using median splits of the respective subscales to identify factors associated with higher fatigue levels.
Results: Among 1511 registry cases, 628 participants had complete fatigue data. Median age was 54 years, 77% were female and most worked in nursing (43%) or educational/care professions (19%). Clinically relevant fatigue was highly prevalent: cognitive fatigue affected 78%-93% and physical fatigue 87%-98%. Both fatigue dimensions were positively correlated with older age, work incapacity and persistent symptom burden. In multivariate analyses, a higher number of acute symptoms was associated with lower odds of cognitive fatigue (adjusted OR 0.39, 95% CI 0.19 to 0.81), while physical fatigue remained associated with profession (adjusted OR 2.04, 95% CI 1.17 to 3.59). Sex, pre-existing conditions, hospitalisation and variant wave were not significant predictors in either model.
Conclusions: Fatigue is a prevalent and disabling PCS-symptom among occupationally exposed workers. Distinct determinants of cognitive and physical fatigue emphasise the need for early recognition, targeted management and rehabilitation strategies to support recovery and work reintegration.
Keywords: COVID-19; Fatigue; Occupational Health Services; Post-Acute COVID-19 Syndrome; REGISTRIES.
. 2026 May 13;16(5):e116993.
doi: 10.1136/bmjopen-2026-116993.
Fatigue after COVID-19 in occupationally exposed workers: prevalence, severity and associated risk factors in a cross-sectional analysis of a multicentre registry study
Kerrin Kobes[SUP] 1 [/SUP], Corinna Rademacher[SUP] 2 [/SUP], Agnessa Kozak[SUP] 3 [/SUP], Andreas Gonschorek[SUP] 4 [/SUP], Ingo Schmehl[SUP] 5 [/SUP], Susann Seddigh[SUP] 6 [/SUP], Andrea Fürst[SUP] 7 [/SUP], Kai Wohlfarth[SUP] 8 9 [/SUP], Lynn Engel[SUP] 2 [/SUP], Jakob Wefers[SUP] 2 [/SUP], Jana Wischnat[SUP] 3 [/SUP], Olaf Kleinmüller[SUP] 10 [/SUP], Albert Nienhaus[SUP] 3 [/SUP], Martin Tegenthoff[SUP] 2 [/SUP], Peter Schwenkreis[SUP] 2 [/SUP]
Affiliations
- PMID: 42128511
- DOI: 10.1136/bmjopen-2026-116993
Objectives: As fatigue is among the most frequent manifestations of post-COVID syndrome (PCS), this study aimed to assess the prevalence and severity of cognitive and physical fatigue after occupational SARS-CoV-2 infection and to identify sociodemographic, clinical and occupational predictors of fatigue severity.
Design: Cross-sectional analysis of a multicentre prospective registry.
Setting: Six German Social Accident Insurance hospitals distributed across Germany, providing standardised post-COVID assessments for individuals with persistent symptoms following occupational SARS-CoV-2 infection.
Participants: Workers with confirmed SARS-CoV-2 infection recognised as an occupational disease or work-related accident who presented with persistent symptoms and were enrolled in a multicentre post-COVID registry.
Primary and secondary outcome measures: Cognitive and physical fatigue severity assessed using validated self-administered questionnaires (Fatigue Scale for Motor and Cognitive Functions, Modified Fatigue Impact Scale and Würzburg Fatigue Inventory for Multiple Sclerosis). Clinical relevance was determined based on established cut-offs reported in the literature. Fatigue severity was operationalised using median splits of the respective subscales to identify factors associated with higher fatigue levels.
Results: Among 1511 registry cases, 628 participants had complete fatigue data. Median age was 54 years, 77% were female and most worked in nursing (43%) or educational/care professions (19%). Clinically relevant fatigue was highly prevalent: cognitive fatigue affected 78%-93% and physical fatigue 87%-98%. Both fatigue dimensions were positively correlated with older age, work incapacity and persistent symptom burden. In multivariate analyses, a higher number of acute symptoms was associated with lower odds of cognitive fatigue (adjusted OR 0.39, 95% CI 0.19 to 0.81), while physical fatigue remained associated with profession (adjusted OR 2.04, 95% CI 1.17 to 3.59). Sex, pre-existing conditions, hospitalisation and variant wave were not significant predictors in either model.
Conclusions: Fatigue is a prevalent and disabling PCS-symptom among occupationally exposed workers. Distinct determinants of cognitive and physical fatigue emphasise the need for early recognition, targeted management and rehabilitation strategies to support recovery and work reintegration.
Keywords: COVID-19; Fatigue; Occupational Health Services; Post-Acute COVID-19 Syndrome; REGISTRIES.