Schmidbauer, Lena, Kirchberger, Inge, Goßlau, Yvonne et al. · Journal of neurology · 2023 · DOI
This study looked at 425 people who had mild-to-moderate COVID-19 treated as outpatients and followed them for about 8 months afterward. Researchers found that 37% of these people developed long-lasting fatigue (Post-COVID-Fatigue), and those who had more symptoms during their initial infection and ongoing symptoms were more likely to experience severe fatigue. The more symptoms someone had, the worse their fatigue tended to be.
This study is significant because it shifts focus from severe COVID-19 hospitalizations to outpatient populations, demonstrating that long-term fatigue affects a substantial proportion of even mildly-infected individuals. Understanding the symptom burden relationship to fatigue severity may help identify high-risk patients early and inform mechanistic research into post-viral fatigue conditions like ME/CFS.
This cross-sectional design cannot establish causation—we cannot determine whether having more symptoms causes worse fatigue or whether both result from an underlying biological process. The study does not identify the biological mechanisms of Post-COVID-Fatigue. Additionally, the predominantly female sample (70%) limits generalizability to men.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Schmidbauer, Lena, Kirchberger, Inge, Goßlau, Yvonne, Warm, Tobias D, Hyhlik-Dürr, Alexander, Linseisen, Jakob, et al. (2023). The association between the number of symptoms and the severity of Post-COVID-Fatigue after SARS-CoV-2 infection treated in an outpatient setting.. Journal of neurology. https://doi.org/10.1007/s00415-023-11752-9
BibTeX
@article{mecfsatlas-schmidbauer-2023-association-between,
author = {Schmidbauer, Lena and Kirchberger, Inge and Goßlau, Yvonne and Warm, Tobias D and Hyhlik-Dürr, Alexander and Linseisen, Jakob and Meisinger, Christa},
title = {The association between the number of symptoms and the severity of Post-COVID-Fatigue after SARS-CoV-2 infection treated in an outpatient setting.},
journal = {Journal of neurology},
year = {2023},
doi = {10.1007/s00415-023-11752-9},
note = {PubMed: 37219607},
url = {https://www.mecfsatlas.com/evidence/schmidbauer-2023-association-between},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/schmidbauer-2023-association-between
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