Objective: Characterization of the clinical features of patients with persistent symptoms after mild to moderate
COVID-19 MESHD infection and exploration of factors associated with the development of Chronic
COVID-19 Syndrome MESHD (CCS). Methods: Setting: Charite Fatigue Center with clinical immunologists and rheumatologist, neurologists and cardiologists at Charite University hospital. Participants: 42 patients who presented with persistent moderate to severe
fatigue MESHD six months following a mostly mild
SARS-CoV-2 infection MESHD at the Charite Fatigue Center from July to November 2020. Main outcome measures: The primary outcomes were clinical and paraclinical data and meeting diagnostic criteria for
Chronic Fatigue Syndrome MESHD (
ME/CFS MESHD). Relevant neurological and cardiopulmonary morbidity was excluded. Results: The median age was 36.5, range 22-62, 29 patients were female and 13 male. At six months post acute
COVID-19 MESHD all patients had
fatigue MESHD (Chalder Fatigue Score median 25 of 33, range 14-32), the most frequent other symptoms were post exertional malaise (n=41),
cognitive symptoms MESHD (n=40),
headache MESHD (n=38), and
muscle pain MESHD (n=35). Most patients were moderately to severely impaired in daily live with a median Bell disability score of 50 (range 15-90) of 100 (healthy) and Short Form 36 (SF36) physical function score of 63 (range 15-80) of 100. 19 of 42 patients fulfilled the 2003 Canadian Consensus Criteria for
myalgic encephalomyelitis/chronic fatigue syndrome MESHD (
ME/CFS MESHD). These patients reported more
fatigue MESHD in the Chalder Fatigue Score (p=0.006), more stress intolerance (p=0.042) and more frequent and longer post exertional malaise (PEM) (p= 0.003), and
hypersensitivity MESHD to noise (p=0.029), light (p=0.0143) and temperature (0.024) compared to patients not meeting
ME/CFS MESHD criteria. Handgrip force was diminished in most patients compared to healthy control values, and lower in CCS/CFS compared to non-CFS CCS (Fmax1 p=0.085, Fmax2, p=0.050, Fmean1 p=0.043, Fmean2 p=0.034, mean of 10 repeat handgrips, 29 female patients). Mannose-binding lectin (
MBL HGNC MBL MESHD) deficiency was observed frequently (22% of all patients) and elevated
IL-8 HGNC levels were found in 43% of patients. Conclusions: Chronic
COVID-19 MESHD Syndrome at months 6 is a multisymptomatic frequently debilitating disease fulfilling diagnostic criteria of
ME/CFS MESHD in about half of the patients in our study. Research in mechanisms and clinical trials are urgently needed.