Abstract overview:
Fatigue is a predominant and persistent symptom of Long-COVID-19 syndrome with high prevalence, and significant impairment of functional status and quality of life.

Aims and objectives:
This study aimed to evaluate the correlation between gestation and post-viral fatigue within the context of Long-COVID syndrome. Another aim of this study was to discern both risk and protective factors for Long-COVID fatigue and the association with the severity of symptoms during the acute phase, maternal age and preexisting comorbidities.

Method:
A total of nine studies, encompassing a range of methodological approaches and study populations, were included. The meta-analysis demonstrated that pregnant individuals exhibited a significantly increased risk of experiencing fatigue compared to non-pregnant controls (pooled odds ratio: 2.12; 95% confidence interval: 1.69–2.65; p < 0.00001). Substantial heterogeneity (I2 = 90%) was noted, primarily due to differences in study design, fatigue assessment tools, and follow-up periods.

Results:
Severe acute-phase COVID-19 symptoms, obesity, and smoking were identified as significant risk factors for the development of fatigue, whereas anosmia appeared to have a protective effect. In certain cases, fatigue persisted for over 12 months, emphasizing its potential for chronicity. Despite the fact that the prevelance of hypertension and diabetes mellitus was high, the associations were not statistically significant. These results highlight the multifactorial etiology of Long COVID-19-related fatigue and its considerable impact on individuals who contracted SARS-CoV-2 during pregnancy.

Conclusion:
Recognizing and addressing fatigue early in pregnant individuals who experienced SARS-CoV- 2 infection is crucial for clinical practice, alongside promoting healthy lifestyle changes. Future research should investigate the role of biomarkers and effective strategies to lessen the burden of this fatigue.