Longitudinal relationships between changes in post-COVID mental fatigue and neuropsychiatric symptoms across distinct recovery trajectories.

IF 5.3 2区医学 Q2 IMMUNOLOGY

Inflammopharmacology Pub Date : 2025-09-01 Epub Date: 2025-08-11 DOI:10.1007/s10787-025-01860-5

Wenrui Bao, Siyuan Chen, Ningkun Hong, Gengchen Ye, Chiyin Li, Jingmei Xie, Peng Li, Heng Li, Yang Wang, Jixin Liu, Xuan Niu, Yuchen Zhang

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引用次数: 0

Abstract

Background: Persistent fatigue, often accompanied by neuropsychiatric symptoms (e.g., cognitive impairment, sleep disorders, depression, anxiety, and PTSD), commonly referred to as "long COVID". Fatigue is multidimensional, comprising physical, psychological, and situational components. However, the relationships between these fatigue dimensions and co-occurring neuropsychiatric symptoms remain unclear. This study aimed to (1) examine the time-varying characteristics of post-COVID fatigue and (2) determine whether specific fatigue dimensions uniquely affect neuropsychiatric symptoms in long COVID.

Methods: We analyzed neuropsychiatric assessments from 233 individuals at 1 and 3 months post-infection using Canonical Correlation Analysis (CCA). Participants were categorized into four groups based on fatigue recovery trajectories: persistent fatigue, alleviated fatigue, new-onset fatigue, and no fatigue. Longitudinal CCA assessed relationships between changes in fatigue dimensions and cognitive impairments (memory, executive function) and psychiatric symptoms (anxiety, depression, PTSD, and sleep disturbances) from the acute to chronic phase.

Results: Physical fatigue was dominant in the acute phase, while mental fatigue became more prominent at 3 months. Across both phases, all fatigue dimensions were strongly associated with depression, anxiety, PTSD, and sleep disturbances, with mental fatigue showing the strongest impact (canonical loadings: ρ = - 0.875 at 1 month; ρ = - 0.914 at 3 months). In the persistent fatigue group, mental fatigue was closely linked to anxiety, depression, and cognitive impairments, including recognition and short-term recall (ρ = - 0.677). No significant longitudinal associations were observed in the alleviated, new-onset, or no-fatigue groups.

Conclusions: Mental fatigue plays a central role in the chronic phase of recovery, significantly impacting cognitive and psychiatric health in individuals with persistent fatigue. Targeted interventions addressing mental fatigue are essential for improving long COVID outcomes.

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在不同的恢复轨迹中，covid后精神疲劳变化与神经精神症状之间的纵向关系

背景：持续性疲劳，常伴有神经精神症状（如认知障碍、睡眠障碍、抑郁、焦虑和创伤后应激障碍），通常被称为“长COVID”。疲劳是多方面的，包括身体、心理和环境因素。然而，这些疲劳维度与同时发生的神经精神症状之间的关系尚不清楚。本研究旨在(1)检验COVID - 19后疲劳的时变特征，(2)确定特定疲劳维度是否对长时间COVID - 19患者的神经精神症状有独特影响。方法：我们使用典型相关分析（CCA）分析233例感染后1和3个月的神经精神评估。参与者根据疲劳恢复轨迹分为四组：持续疲劳、缓解疲劳、新发疲劳和无疲劳。纵向CCA评估从急性期到慢性期疲劳维度变化与认知障碍（记忆、执行功能）和精神症状（焦虑、抑郁、创伤后应激障碍和睡眠障碍）之间的关系。结果：急性期以体力疲劳为主，3个月时精神疲劳更为突出。在这两个阶段，所有疲劳维度都与抑郁、焦虑、创伤后应激障碍和睡眠障碍密切相关，其中精神疲劳的影响最大(典型负荷：1个月时ρ = - 0.875；3个月时ρ = - 0.914)。在持续性疲劳组中，精神疲劳与焦虑、抑郁和认知障碍（包括识别和短期回忆）密切相关（ρ = - 0.677）。在缓解组、新发组或无疲劳组中未观察到显著的纵向关联。结论：精神疲劳在慢性恢复期起核心作用，显著影响持续性疲劳个体的认知和精神健康。针对精神疲劳的有针对性的干预措施对于改善COVID - 19的长期结果至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Inflammopharmacology IMMUNOLOGYTOXICOLOGY-TOXICOLOGY

CiteScore

8.00

自引率

3.40%

发文量

200

期刊介绍： Inflammopharmacology is the official publication of the Gastrointestinal Section of the International Union of Basic and Clinical Pharmacology (IUPHAR) and the Hungarian Experimental and Clinical Pharmacology Society (HECPS). Inflammopharmacology publishes papers on all aspects of inflammation and its pharmacological control emphasizing comparisons of (a) different inflammatory states, and (b) the actions, therapeutic efficacy and safety of drugs employed in the treatment of inflammatory conditions. The comparative aspects of the types of inflammatory conditions include gastrointestinal disease (e.g. ulcerative colitis, Crohn''s disease), parasitic diseases, toxicological manifestations of the effects of drugs and environmental agents, arthritic conditions, and inflammatory effects of injury or aging on skeletal muscle. The journal has seven main interest areas: -Drug-Disease Interactions - Conditional Pharmacology - i.e. where the condition (disease or stress state) influences the therapeutic response and side (adverse) effects from anti-inflammatory drugs. Mechanisms of drug-disease and drug disease interactions and the role of different stress states -Rheumatology - particular emphasis on methods of measurement of clinical response effects of new agents, adverse effects from anti-rheumatic drugs -Gastroenterology - with particular emphasis on animal and human models, mechanisms of mucosal inflammation and ulceration and effects of novel and established anti-ulcer, anti-inflammatory agents, or antiparasitic agents -Neuro-Inflammation and Pain - model systems, pharmacology of new analgesic agents and mechanisms of neuro-inflammation and pain -Novel drugs, natural products and nutraceuticals - and their effects on inflammatory processes, especially where there are indications of novel modes action compared with conventional drugs e.g. NSAIDs -Muscle-immune interactions during inflammation [...]