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Multidimensional fatigue interactions are associated with autonomic and cardio-respiratory changes in post-COVID-19 patients

In post-COVID-19 patients, daily changes in fatigue dimensions (physical, cognitive, emotional) were associated with fluctuations in heart rate variability and respiratory measures, particularly during sleep. The interaction of multiple fatigue dimensions showed more consistent associations than single dimensions, with patterns suggesting sympathetic dominance with higher physical fatigue and parasympathetic dominance with increases in cognitive and emotional fatigue.

Last updated: Aug 5, 2026•0 RCTs•📖 Read as article →

Evidence Score

Evidence Score32/100
Human RCT☆☆☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Associations between multidimensional fatigue and wearable-derived cardio-respiratory variables in post-COVID-19 patients: an observational study.

observational

Adão Martins NR, Annaheim S, Büche D, Rossi RM, Spengler CM · Frontiers in digital health (2026)

Participants: N/A
Duration: 29.6 ± 10.2 days (rehabilitation stay)
Intervention: Observational study of fatigue dimensions and physiological variables (no intervention)
Outcome: Resting heart rate, sample entropy of RR intervals, LF peak frequency, LF/HF ratio, respiratory rate, blood oxygen saturation
Effect Size: N/A
Population: 30 post-COVID-19 patients (11 male, 19 female, mean age 44.1 ± 12.7 years) during rehabilitation stay

Result:

PubMed: 42535033DOI: 10.3389/fdgth.2026.1804993

Mechanism Graph

Fatigue dimensions (physical, cognitive, emotional) are measured via self-report four times daily
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Wearable sensors continuously record ECG, respiratory rate, and blood oxygen saturation during day and night
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Linear mixed models assess associations between daily fatigue scores and physiological variables
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Interactions among fatigue dimensions show significant associations with heart rate variability measures, indicating shifts in autonomic balance

Limitations

  • ⚠Small sample size (n=30) limits generalizability
  • ⚠Observational design cannot establish causality
  • ⚠Potential confounding from unmeasured factors (e.g., medication, activity levels) despite adjustments

Frequently Asked Questions

What fatigue dimensions were studied?▼

Physical, cognitive, and emotional fatigue were assessed via mobile app four times daily.

How were physiological variables measured?▼

ECG, respiratory rate, and blood oxygen saturation were recorded continuously via wearable sensors during at least 2 monitoring weeks.

What were the main findings?▼

Daily changes in fatigue were associated with fluctuations in heart rate variability, especially during sleep. Higher physical fatigue was linked to sympathetic dominance, while increases in cognitive and emotional fatigue were linked to parasympathetic dominance.

Why is the interaction of fatigue dimensions important?▼

The interaction of multiple fatigue dimensions showed more consistent associations with physiological changes than single dimensions, suggesting fatigue should be treated as a multidimensional construct.

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References

  1. 1.Adão Martins NR, Annaheim S, Büche D, Rossi RM, Spengler CM. "Associations between multidimensional fatigue and wearable-derived cardio-respiratory variables in post-COVID-19 patients: an observational study.." Frontiers in digital health, 2026. PMID: 42535033 DOI: 10.3389/fdgth.2026.1804993
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.