Identifying central symptom clusters and correlates among post-COVID-19 pulmonary fibrosis patients: a network analysis

BackgroundPrevious studies have analyzed symptom clusters in patients with coronavirus disease 2019 (COVID-19); however, evidence regarding the core symptom clusters and their influencing factors in patients with post-COVID-19 pulmonary fibrosis (PCPF) remains unclear, affecting the precision of sym...

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Main Authors: Zhen Yang, Zhiqin Xie, Zequan Wang, Linxia Yi, Shihan Chen, Yunyu Du, Xuemei Tao, Chao Xie, Li Zhou, Min Zhang, Chaozhu He
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1538708/full
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author Zhen Yang
Zhen Yang
Zhiqin Xie
Zequan Wang
Zequan Wang
Linxia Yi
Linxia Yi
Shihan Chen
Shihan Chen
Yunyu Du
Xuemei Tao
Xuemei Tao
Chao Xie
Chao Xie
Li Zhou
Min Zhang
Chaozhu He
author_facet Zhen Yang
Zhen Yang
Zhiqin Xie
Zequan Wang
Zequan Wang
Linxia Yi
Linxia Yi
Shihan Chen
Shihan Chen
Yunyu Du
Xuemei Tao
Xuemei Tao
Chao Xie
Chao Xie
Li Zhou
Min Zhang
Chaozhu He
author_sort Zhen Yang
collection DOAJ
description BackgroundPrevious studies have analyzed symptom clusters in patients with coronavirus disease 2019 (COVID-19); however, evidence regarding the core symptom clusters and their influencing factors in patients with post-COVID-19 pulmonary fibrosis (PCPF) remains unclear, affecting the precision of symptom interventions.ObjectivesThis study aimed to identify the symptom clusters and core symptom clusters in patients with PCPF. Demographic and disease-related factors associated with these symptom clusters were also analyzed.MethodsA total of 350 patients with PCPF were recruited from China between January 2023 and April 2024. A self-reported symptom assessment scale was used for this survey. Principal component analysis was used to identify symptom clusters. Network analysis was used to describe the relationships between the symptoms and symptom clusters. Multiple linear models were used to analyze the factors affecting the total symptom severity and each symptom cluster.ResultsSix symptom clusters were identified: Upper Respiratory Tract Symptom Cluster (USC), Lower Respiratory Tract Symptom Cluster (LSC), Somatic Symptom Cluster (SSC), Muscular and Joint Symptom Cluster (MSC), Neurological and Psychological Symptom Cluster (NSC), and Digestive Symptom Cluster (DSC). Fatigue was identified as the core and bridge symptom in the symptom network, whereas the upper respiratory symptom cluster was identified as the core and bridge symptom cluster. Gender, age, educational level, smoking history, and primary caregiver were associated with the scores of the six symptom clusters.ConclusionOur study suggests that there is a need to evaluate symptom clusters for the improvement of symptom management among PCPF. Specifically, the assessment and treatment of upper respiratory and fatigue symptoms as core targets of PCPF care is critical for the development of accurate and efficient symptom management strategies.
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spelling doaj-art-19a72f98bb4c469a9b9ef0dfd513e8102025-08-20T03:13:39ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-05-011210.3389/fmed.2025.15387081538708Identifying central symptom clusters and correlates among post-COVID-19 pulmonary fibrosis patients: a network analysisZhen Yang0Zhen Yang1Zhiqin Xie2Zequan Wang3Zequan Wang4Linxia Yi5Linxia Yi6Shihan Chen7Shihan Chen8Yunyu Du9Xuemei Tao10Xuemei Tao11Chao Xie12Chao Xie13Li Zhou14Min Zhang15Chaozhu He16Department of nursing, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, ChinaSchool of Nursing, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, ChinaJiangxi Medical Center for Critical Public Health Events, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, ChinaDepartment of nursing, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, ChinaSchool of Nursing, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, ChinaDepartment of nursing, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, ChinaSchool of Nursing, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, ChinaDepartment of nursing, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, ChinaSchool of Nursing, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, ChinaDepartment of Thoracic Surgery, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, ChinaDepartment of nursing, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, ChinaSchool of Nursing, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, ChinaDepartment of nursing, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, ChinaSchool of Nursing, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, ChinaJiangxi Medical Center for Critical Public Health Events, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, ChinaJiangxi Medical Center for Critical Public Health Events, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, ChinaSchool of Nursing, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, ChinaBackgroundPrevious studies have analyzed symptom clusters in patients with coronavirus disease 2019 (COVID-19); however, evidence regarding the core symptom clusters and their influencing factors in patients with post-COVID-19 pulmonary fibrosis (PCPF) remains unclear, affecting the precision of symptom interventions.ObjectivesThis study aimed to identify the symptom clusters and core symptom clusters in patients with PCPF. Demographic and disease-related factors associated with these symptom clusters were also analyzed.MethodsA total of 350 patients with PCPF were recruited from China between January 2023 and April 2024. A self-reported symptom assessment scale was used for this survey. Principal component analysis was used to identify symptom clusters. Network analysis was used to describe the relationships between the symptoms and symptom clusters. Multiple linear models were used to analyze the factors affecting the total symptom severity and each symptom cluster.ResultsSix symptom clusters were identified: Upper Respiratory Tract Symptom Cluster (USC), Lower Respiratory Tract Symptom Cluster (LSC), Somatic Symptom Cluster (SSC), Muscular and Joint Symptom Cluster (MSC), Neurological and Psychological Symptom Cluster (NSC), and Digestive Symptom Cluster (DSC). Fatigue was identified as the core and bridge symptom in the symptom network, whereas the upper respiratory symptom cluster was identified as the core and bridge symptom cluster. Gender, age, educational level, smoking history, and primary caregiver were associated with the scores of the six symptom clusters.ConclusionOur study suggests that there is a need to evaluate symptom clusters for the improvement of symptom management among PCPF. Specifically, the assessment and treatment of upper respiratory and fatigue symptoms as core targets of PCPF care is critical for the development of accurate and efficient symptom management strategies.https://www.frontiersin.org/articles/10.3389/fmed.2025.1538708/fullCOVID-19pulmonary fibrosislung diseasesinterstitialsyndromesocial network analysis
spellingShingle Zhen Yang
Zhen Yang
Zhiqin Xie
Zequan Wang
Zequan Wang
Linxia Yi
Linxia Yi
Shihan Chen
Shihan Chen
Yunyu Du
Xuemei Tao
Xuemei Tao
Chao Xie
Chao Xie
Li Zhou
Min Zhang
Chaozhu He
Identifying central symptom clusters and correlates among post-COVID-19 pulmonary fibrosis patients: a network analysis
Frontiers in Medicine
COVID-19
pulmonary fibrosis
lung diseases
interstitial
syndrome
social network analysis
title Identifying central symptom clusters and correlates among post-COVID-19 pulmonary fibrosis patients: a network analysis
title_full Identifying central symptom clusters and correlates among post-COVID-19 pulmonary fibrosis patients: a network analysis
title_fullStr Identifying central symptom clusters and correlates among post-COVID-19 pulmonary fibrosis patients: a network analysis
title_full_unstemmed Identifying central symptom clusters and correlates among post-COVID-19 pulmonary fibrosis patients: a network analysis
title_short Identifying central symptom clusters and correlates among post-COVID-19 pulmonary fibrosis patients: a network analysis
title_sort identifying central symptom clusters and correlates among post covid 19 pulmonary fibrosis patients a network analysis
topic COVID-19
pulmonary fibrosis
lung diseases
interstitial
syndrome
social network analysis
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1538708/full
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