# Fatigue and Fatigability in Veterans Following SARS-CoV-2 Infection

> **NIH VA I21** · U.S. DEPT/VETS AFFAIRS MEDICAL CENTER · 2024 · —

## Abstract

Project Summary/Abstract
The chronic presence of elevations in fatigue suggests that individuals with post-COVID-19 fatigue (PCF) may
be at risk for experiencing increased fatigability when engaging in physical activity. An individual’s level of
fatigability is determined by the interactions between objective declines in performance (performance
fatigability) and perceptual changes regulating activity performance (i.e., perceived fatigability). Skeletal
muscle alterations including reduced force capacity, fiber atrophy, and metabolic dysfunction have been
observed in patients following SARS-CoV-2 infection. In addition, depression and anxiety have been identified
as common pre-existing conditions in patients with PCF. Thus, psychological as well as physiological
consequences of SARS-CoV-2 may provide insight into co-occurring mechanisms by which increased
fatigability occurs and persists following SARS-CoV-2 infection. While there have been widespread calls for the
implementation of rehabilitation for individuals recovering from SARS-CoV-2 infection, relatively little is
known about the potential benefits of physical exercise in this population. Home-based exercise programs
maybe particularly advantageous due to its ability to provide an exercise option to combat sedentary behavior
imposed by lockdowns, quarantines, and restrictions on community activity caused by the COVID-19
pandemic. To date, the safety and feasibility of home-based exercise has yet to be thoroughly investigated in
people previously infected by SARS-CoV-2. The overall goal of this project is to advance our understanding of
underlying mechanisms impacting performance fatigability and perceived fatigability in Veterans with PCF and
explore the safety and feasibility of a home-based “minimal-dose” resistance exercise program in this
population. The central hypothesis is that declines in force capacity, skeletal muscle oxygen extraction, and
affective responses to physical activity offer potential mechanisms through which fatigability is increased in
Veterans with PCF. Moreover, home-based resistance exercise delivered remotely may provide a safe and
feasible treatment option for this population. To address this hypothesis, the following aims are proposed: Aim
1: Compare fatigability, and the underlying neuromuscular and neurobiological factors, in Veterans with post-
COVID-19 fatigue to Veterans previously infected by SARS-CoV-2 without fatigue. Hypothesis 1a. Veterans
with post-COVID-19 fatigue will exhibit greater performance fatigability and perceived fatigability compared to
Veterans previously infected with SARS-CoV-2 not reporting post-COVID-19 fatigue. Hypothesis 1b. Veterans
with post-COVID-19 fatigue will exhibit reductions in knee extensor force capacity, muscle oxygen extraction,
and affective valence compared to Veterans previously infected with SARS-CoV-2 not reporting post-COVID-19
fatigue. Aim 2: Determine the safety and feasibility of an 8-week home-based “minimal...

## Key facts

- **NIH application ID:** 10873177
- **Project number:** 5I21RX004371-02
- **Recipient organization:** U.S. DEPT/VETS AFFAIRS MEDICAL CENTER
- **Principal Investigator:** JARED M. GOLLIE
- **Activity code:** I21 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2024
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2023-07-01 → 2025-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10873177

## Citation

> US National Institutes of Health, RePORTER application 10873177, Fatigue and Fatigability in Veterans Following SARS-CoV-2 Infection (5I21RX004371-02). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10873177. Licensed CC0.

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