{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T15:12:26Z","timestamp":1778685146459,"version":"3.51.4"},"reference-count":36,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"unspecified","delay-in-days":12,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"German Social Accident Insurance provider for non-state institutions within the health and welfare service sectors","award":["1549"],"award-info":[{"award-number":["1549"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,4,29]]},"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional analysis of a multicentre prospective registry.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>Cognitive and physical fatigue severity assessed using validated self-administered questionnaires (Fatigue Scale for Motor and Cognitive Functions, Modified Fatigue Impact Scale and W\u00fcrzburg 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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%\u201393% and physical fatigue 87%\u201398%. 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%\u2009CI 0.19 to 0.81), while physical fatigue remained associated with profession (adjusted OR 2.04, 95%\u2009CI 1.17 to 3.59). Sex, pre-existing conditions, hospitalisation and variant wave were not significant predictors in either model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-116993","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T14:25:45Z","timestamp":1778682345000},"page":"e116993","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Fatigue after COVID-19 in occupationally exposed workers: prevalence, severity and associated risk factors in a cross-sectional analysis of a multicentre registry study"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-1628-7444","authenticated-orcid":false,"given":"Kerrin","family":"Kobes","sequence":"first","affiliation":[{"name":"Institute for Health Services Research in Dermatology and Nursing, University Medical Center 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Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1795-0714","authenticated-orcid":false,"given":"Susann","family":"Seddigh","sequence":"additional","affiliation":[{"name":"BG Klinikum Duisburg, Duisburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"F\u00fcrst","sequence":"additional","affiliation":[{"name":"BGU Murnau, Murnau am Staffelsee, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kai","family":"Wohlfarth","sequence":"additional","affiliation":[{"name":"BG Hospital Bergmanntrost Halle, Halle (Saale), Germany"},{"name":"HMU Health and Medical University Erfurt GmbH, Erfurt, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lynn","family":"Engel","sequence":"additional","affiliation":[{"name":"BG University Hospital Bergmannsheil Bochum, Bochum, 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Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Tegenthoff","sequence":"additional","affiliation":[{"name":"BG University Hospital Bergmannsheil Bochum, Bochum, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2934-3923","authenticated-orcid":false,"given":"Peter","family":"Schwenkreis","sequence":"additional","affiliation":[{"name":"BG University Hospital Bergmannsheil Bochum, Bochum, 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