Bao Wenrui, Chen Siyuan, Hong Ningkun, Ye Gengchen, Li Chiyin, Xie Jingmei, Li Peng, Li Heng, Wang Yang, Liu Jixin, Niu Xuan, Zhang Yuchen
Department of Nuclear Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.
School of Future Technology, Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.
Inflammopharmacology. 2025 Aug 11. doi: 10.1007/s10787-025-01860-5.
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.
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“长新冠”。疲劳是多维度的，包括身体、心理和情境成分。然而，这些疲劳维度与同时出现的神经精神症状之间的关系仍不清楚。本研究旨在（1）检查新冠后疲劳的时变特征，以及（2）确定特定的疲劳维度是否对长新冠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）对233名个体在感染后1个月和3个月时的神经精神评估进行了分析。参与者根据疲劳恢复轨迹分为四组：持续性疲劳、缓解性疲劳、新发疲劳和无疲劳。纵向CCA评估了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：身体疲劳在急性期占主导地位，而精神疲劳在3个月时变得更加突出。在两个阶段中，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强（典型载荷：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、抑郁和认知障碍密切相关，包括识别和短期记忆（ρ = -0.677）。在缓解性、新发或无疲劳组中未观察到显著的纵向关联。 结论：精神疲劳在恢复的慢性期起着核心作用，对持续性疲劳个体的认知和精神健康有显著影响。针对精神疲劳的针对性干预对于改善长新冠的预后至关重要。
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