Somatosensory processing in long COVID fatigue and its relations with physiological and psychological factors [Results]

Thomas, Bethan ORCID: https://orcid.org/0009-0002-0294-6839, Pattinson, Rachael ORCID: https://orcid.org/0000-0002-3145-3710, Cunningham, Geoffrey, Bundy, Christine ORCID: https://orcid.org/0000-0002-5981-3984 and Davies, Jennifer L. ORCID: https://orcid.org/0000-0001-7635-4815 2026. Somatosensory processing in long COVID fatigue and its relations with physiological and psychological factors [Results]. Experimental Physiology 10.1113/ep093600

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Abstract

We aimed to quantify somatosensory processing in long COVID and interactions between somatosensory processing, fatigability, fatigue, autonomic function, mood and illness beliefs. Eighty-eight participants (44 long COVID and 44 controls) were invited to complete two testing sessions, where fatigue was induced by either a cognitive or a physical task in a cross-over design; all participants completed at least one session. Baseline questionnaires assessed trait fatigue, autonomic symptoms, mood and illness beliefs. Pre- and post-task measures included somatosensory processing, state fatigue, perceived effort and heart rate variability (HRV). Group differences and task-related changes were analysed using multivariate and linear mixed models. There was no multivariate group effect on baseline somatosensory measures (P = 0.172), nor did they change following exertion or associate with post-exertion fatigue. Long COVID participants reported greater fatigue than controls, with 64% meeting criteria for severe fatigue. State fatigue was greater at baseline, throughout both exertion tasks (all P < 0.001), and increased more during exertion compared with controls. Despite this, cognitive and physical performance changed similarly across tasks, with no group differences in fatigability (P = 0.199–0.441). Long COVID participants had lower resting HRV, indicating autonomic dysfunction, but HRV was not associated with fatigue. Only group status (P < 0.001) and pre-task fatigue (P < 0.001) were associated with post-exertion fatigue. Within long COVID participants, greater depression (P < 0.001) and perceived illness threat (P = 0.033) were associated with greater trait fatigue. The absence of somatosensory abnormalities provides no support for the sensory attenuation model of fatigue in long COVID.

Item Type:	Article
Date Type:	Published Online
Status:	In Press
Schools:	Schools > Dentistry Schools > Healthcare Sciences
Publisher:	Wiley
ISSN:	0958-0670
Date of First Compliant Deposit:	29 September 2026
Last Modified:	29 Sep 2026 11:45
URI:	https://orca.cardiff.ac.uk/id/eprint/189891

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