Symptom-based survey diagnoses may serve to identify more homogenous sub-groups of fatigue and postviral diseases

Abstract

Background and objective: A range of diagnostic criteria are applied for the heterogenous patient group with fatigue or postviral fatigue syndromes with or without Post Exertional Malaise (PEM). We explored whether DePaul Symptom Questionnaires (DSQ) based symptoms reported in an open online survey called MECOV, served to identify more homogenous sub-groups. Method: Patients living in Norway were invited to participate in an open online survey in 2022. The questionnaire covered diagnostic history, SARS-CoV-2, general health, RAND-36 and DSQ symptoms, treatments and background information. Results: 2362 patients responded to the survey. 1904 respondents had Fatigue or Postviral disease. 1026 fulfilled CCC criteria with multi-dimensional PEM and 14 h recovery period or ICC criteria for ME. 384 fulfilled IOM/NICE or CCC criteria with only less rigid PEM, while 494 respondents fulfilled only broad fatigue and Fukuda criteria. Self-reported health status, number of treatments tried, and reported effect of activity-based treatments varied significantly across the three groups. Conclusion: DSQ symptom-based survey diagnoses served to identify more homogenous subgroups of patients with Fatigue or Postviral diseases (ME and CFS) and may serve as a valid supplement to standard medical examinations. Symptoms, treatment, management strategies and further research may gain from being tailored to the three sub-groups.