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Fatigue is a signature symptom of viruses like coronavirus (including SARS-CoV-2, the virus that causes COVID-19), influenza, SARS, or mumps. After their course has run, many people feel better immediately. However, that is not always the case. If you are still left feeling tired or having lingering symptoms, it is possible you are experiencing post-viral fatigue. Let’s take a look at what this condition is and what can be done to diagnose and treat it.
What is post-viral fatigue?
Post-viral fatigue or post-viral fatigue syndrome is a condition that happens after a viral infection, where a person is drained of energy and generally feels unwell, even after the infection is gone. This is due to the remaining inflammation in the body and in the brain. It is classified as a disease of the nervous system.
This can sometimes be referred to as an “invisible symptom” as it can be hard for people to describe. Oftentimes sleeping does not relieve the extreme tiredness associated with post-viral fatigue and it can lead to physical and mental exhaustion. Certain individuals even experience multiple lingering symptoms from the virus such as sore throat, swollen lymph nodes, joint pain, cough, brain fog, trouble concentrating, or muscle pains. Post-viral fatigue may last days to months, meaning it may impact a person's quality of life and well-being making it difficult to find the energy to participate in daily activities such as school, work, and relationships.
Post-viral fatigue is being studied more during the pandemic as it is a common symptom of recovering COVID-19 patients. The prevalence is not known, but The Centers for Disease Control found in July of 2020 that 35% of patients that have had COVID-19 had not returned to their usual state of health post-covid, with cough and fatigue being the number one lingering symptoms.
Research has also found that viral infections and infectious diseases have been linked to long-term fatigue conditions including chronic fatigue syndrome (CFS), also known as, myalgic encephalomyelitis (ME).
How is post-viral fatigue diagnosed?
“We have been hearing a lot about the syndrome recently as a potential long-term effect of COVID-19,” says Dr. Lili Barsky, an LA-based hospitalist and urgent-care physician, “but post-viral fatigue syndrome has been identified and studied in association with multiple common viral infections, including flu, enterovirus, Epstein Barr virus (which causes mononucleosis), herpes and HIV, among others. Post-viral fatigue syndrome is thought to be due to "cytokine storm," or the release of inflammatory mediators caused by the effects of the virus on the immune system.”
Post-viral fatigue can happen to anyone. It has been associated with children, young adults, adults, and the elderly. Physical health and fitness levels prior to the virus also do not seem to have an effect on determining who may get post-viral fatigue. The severity and length of the virus is also not an indicator of who may be at risk, as some people with mild illness may go on to have prolonged fatigue afterward.
There is not a specific test to diagnose post-viral fatigue.
“It is important for anyone with prolonged fatigue after a viral illness to visit their physician for further evaluation and management. There may be a treatable underlying cause for someone's post-infectious fatigue,” explained Dr. Barsky.
Other possibilities causing a person’s fatigue may be complications from the infection such as dehydration, anemia, or an electrolyte imbalance. After ruling out these possibilities, a physician can make a diagnosis. As post-viral fatigue is only caused by the inflammation from the virus itself, all other possibilities must be tested first.
If you suspect you or a loved one has post-viral fatigue, you can make an appointment with your primary care physician or a general practitioner. They will ask you about the course of your viral infection, run blood or urine tests to rule out other possibilities, and possibly order a sleep study to determine it isn’t a sleep disturbance causing your severe fatigue.
Post-viral fatigue treatment options
There are currently no specific treatments for post-viral fatigue. Due to this, symptoms of post-viral fatigue will be treated individually. Medications are an option to treat any symptoms as a result of post-viral fatigue, such as aspirin for muscle pain. Lifestyle changes can also be helpful to cope with fatigue, such as resting and doing relaxation techniques. Support groups are also helpful for those with debilitating symptoms.
Post-viral fatigue medications
There is no specific medication to treat post-viral fatigue. Possible medications may include pain medicines for muscle aches, such as ibuprofen.
What is the best medication for post-viral fatigue?
| Best medications for post-viral fatigue | ||||
|---|---|---|---|---|
| Drug Name | Drug Class | Administration Route | Standard Dosage | Common Side Effects |
| Ibuprofen | Nonsteroidal Anti-inflammatory Agents (NSAIDs) | Oral | 200 to 400 mg orally every 4 hours as needed | Hemorrhage, vomiting, anemia |
Dosage is determined by your doctor based on your medical condition, response to treatment, age, and weight. Other possible side effects exist. This is not a complete list.
What are the common side effects of post-viral fatigue medication?
Hemorrhage, vomiting, and anemia are some of the commonly reported side effects of ibuprofen. Before taking any new medications consult first with your healthcare professional.
What is the best home remedy for post-viral fatigue?
“Management for post-viral fatigue syndrome involves symptomatic management, a good sleep routine, a well-balanced diet and drinking plenty of fluids,” says Dr. Barsky, “Some studies also suggest there may be a role for stress reduction techniques like yoga, acupuncture, massage and/or cognitive behavioral therapy.”
For those that have ME/CFS, there are clinical studies organized by the National Institute of Health to help find cures. There are also support groups available.
Frequently asked questions about post-viral fatigue
Why do I feel so tired after a viral infection?
Inflammation remains in the body after an initial infection. If you continue to have health problems as a result of the virus, this could be caused by the condition known as post-viral fatigue syndrome.
Is it normal that I feel tired after recovering from COVID-19?
Yes, it is normal for the body to be tired after a viral infection while it heals. Continued fatigue and post-viral symptoms after the initial virus has run its course, could be an indicator of post-viral fatigue.
How do I get rid of fatigue after the flu?
Management for fatigue after the flu involves a good sleep routine, staying hydrated, and eating a well-balanced diet. Stress reduction techniques may also help if symptoms continue to occur.
What is the best antidepressant for fatigue?
Antidepressants are sometimes prescribed for chronic fatigue syndrome. The most commonly prescribed drug classes are tricyclics and selective serotonin reuptake inhibitors.