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Review: patients with infectious mononucleosis have long lasting fatigue, and poor physical functioning predicts delayed recovery

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 QUESTION: In patients with infectious mononucleosis (IM), how frequent are chronic symptoms? Are any risk factors associated with chronic symptoms? Which interventions, if any, are preventive?

Data sources

Studies were identified by searching Medline, EMBASE/Excerpta Medica, PsycINFO, and CINAHL (to October 2001) and the Science and Social Sciences citation indices (to November 2001). The references of retrieved studies were checked.

Study selection

English language studies were selected if they were cohort or intervention studies that explored the course of illness for >6 weeks after onset in uncomplicated IM.

Data extraction

A standard form was used to extract data on study design and methods, setting, patient characteristics, study purpose, definition of IM, ill health and recovery, predictors of delayed recovery, and main study outcomes.

Main results

16 articles of 14 studies (2 randomised controlled trials [RCTs], 1 quasi-RCT, 7 prospective cohort studies, and 4 retrospective cohort studies) were included. Sample sizes ranged from 25–337 patients, and follow up ranged from 2 months to 2 years. 5 studies reported <80% follow up and are not included in …

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  • Source of funding: not stated.

  • For correspondence: Dr M Hotopf, Guy’s King’s and St Thomas’ School of Medicine, London, UK. M.hotopf{at}