The association of post-COVID-19 fatigue in the acute phase with neuropsychiatric and neurocognitive symptoms trajectory over time and long-term health-related quality of life among Chinese adults
Abstract Background Post-viral fatigue is a common and debilitating neurological sequela of COVID-19, often accompanied with multidimensional neuropsychiatric symptoms (post-viral fatigue, sleep disturbance, anxiety, depression, and post-traumatic stress disorder) and neurocognitive impairment. We s...
Saved in:
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-05-01
|
| Series: | Health and Quality of Life Outcomes |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12955-025-02384-w |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849704307232866304 |
|---|---|
| author | Qiange Zhu Xingpu Quan Zhaoyao Luo Yu Shang Xinyi Zhu Wenrui Bao Meiling Shang Peng Li Fan Gao Wenyang Wang Ziyi Liu Xuan Niu Yuchen Zhang |
| author_facet | Qiange Zhu Xingpu Quan Zhaoyao Luo Yu Shang Xinyi Zhu Wenrui Bao Meiling Shang Peng Li Fan Gao Wenyang Wang Ziyi Liu Xuan Niu Yuchen Zhang |
| author_sort | Qiange Zhu |
| collection | DOAJ |
| description | Abstract Background Post-viral fatigue is a common and debilitating neurological sequela of COVID-19, often accompanied with multidimensional neuropsychiatric symptoms (post-viral fatigue, sleep disturbance, anxiety, depression, and post-traumatic stress disorder) and neurocognitive impairment. We sought to characterize the trajectory of these neurological symptoms and investigate the relationship between acute-phase fatigue (< 1 month) and the chronicity of neuropsychiatric and neurocognitive symptoms, as well as long-term health-related quality of life (HRQoL) at 3 months post-infection. Methods A prospective, multi-center, longitudinal study was conducted from January to February 2023 within a cohort of individuals with a mild SARS-COV-2 infection and contemporaneous healthy controls (HCs). Comprehensive neuropsychiatric and neurocognitive assessments were collected for COVID-19 survivors during both acute and chronic phase post-infection, with the EQ-5D-5L (a standardized instrument for assessing HRQoL) evaluated at the chronic phase. Healthy controls underwent the same protocol for recruitment to the study. Linear mixed models were used to access the impact of acute-phase fatigue on different neuropsychiatric and neurocognitive scales over time. Results Three hundred thirty-five COVID-19 survivors and 79 HCs were included in the study. COVID-19 survivors exhibited poorer performance in various neuropsychiatric domains during the acute phase, with the exception of cognitive impairment. A significant amelioration of emotional symptoms, including anxiety and depression, was observed from the acute to chronic phase among COVID-19 survivors, reaching levels comparable to those of HCs. However, at 3 months post-infection, survivors continued to report higher levels of fatigue and poorer sleep quality compared to HCs, although the differences had diminished from the acute phase. The impact of the pandemic event persisted, and no significant changes in cognitive performance were observed. Acute-phase fatigue was associated with poorer sleep and worse emotional problems during the recovery process (from the acute to the chronic phase), and further exacerbated overall HRQoL at 3 months post-infection (EQ index score, p = 0.001, Cohen's d = -0.33; EQ-VAS, p = 0.007, Cohen's d = -0.19). Conclusions Our findings provide novel evidence on the distinct temporal trajectories for post-acute COVID-19 sequelae in a longitudinal study, highlighting the negative impact of acute-phase fatigue on the process of neuropsychiatric recovery and long-term HRQoL. |
| format | Article |
| id | doaj-art-d87c8f5be0b241c483ffd41c23660f70 |
| institution | DOAJ |
| issn | 1477-7525 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Health and Quality of Life Outcomes |
| spelling | doaj-art-d87c8f5be0b241c483ffd41c23660f702025-08-20T03:16:47ZengBMCHealth and Quality of Life Outcomes1477-75252025-05-0123111310.1186/s12955-025-02384-wThe association of post-COVID-19 fatigue in the acute phase with neuropsychiatric and neurocognitive symptoms trajectory over time and long-term health-related quality of life among Chinese adultsQiange Zhu0Xingpu Quan1Zhaoyao Luo2Yu Shang3Xinyi Zhu4Wenrui Bao5Meiling Shang6Peng Li7Fan Gao8Wenyang Wang9Ziyi Liu10Xuan Niu11Yuchen Zhang12Department of Medical Imaging, the First Affiliated Hospital of Xi’an Jiaotong UniversityDepartment of Medical Imaging, the First Affiliated Hospital of Xi’an Jiaotong UniversityDepartment of Medical Imaging, the First Affiliated Hospital of Xi’an Jiaotong UniversitySchool of Future Technology, Xi’an Jiaotong UniversityDepartment of Medical Imaging, the First Affiliated Hospital of Xi’an Jiaotong UniversitySchool of Future Technology, Xi’an Jiaotong UniversitySchool of Future Technology, Xi’an Jiaotong UniversityDepartment of Radiology, the Second Hospital of the Air Force Medical UniversityDepartment of Clinical Research Centre, the First Affiliated Hospital of Xi’an Jiaotong UniversityDepartment of Medical Imaging, the First Affiliated Hospital of Xi’an Jiaotong UniversityHealth Science Center, Xi’an Jiaotong UniversityDepartment of Medical Imaging, the First Affiliated Hospital of Xi’an Jiaotong UniversityDepartment of Nuclear Medicine, the First Affiliated Hospital of Xi’an Jiaotong UniversityAbstract Background Post-viral fatigue is a common and debilitating neurological sequela of COVID-19, often accompanied with multidimensional neuropsychiatric symptoms (post-viral fatigue, sleep disturbance, anxiety, depression, and post-traumatic stress disorder) and neurocognitive impairment. We sought to characterize the trajectory of these neurological symptoms and investigate the relationship between acute-phase fatigue (< 1 month) and the chronicity of neuropsychiatric and neurocognitive symptoms, as well as long-term health-related quality of life (HRQoL) at 3 months post-infection. Methods A prospective, multi-center, longitudinal study was conducted from January to February 2023 within a cohort of individuals with a mild SARS-COV-2 infection and contemporaneous healthy controls (HCs). Comprehensive neuropsychiatric and neurocognitive assessments were collected for COVID-19 survivors during both acute and chronic phase post-infection, with the EQ-5D-5L (a standardized instrument for assessing HRQoL) evaluated at the chronic phase. Healthy controls underwent the same protocol for recruitment to the study. Linear mixed models were used to access the impact of acute-phase fatigue on different neuropsychiatric and neurocognitive scales over time. Results Three hundred thirty-five COVID-19 survivors and 79 HCs were included in the study. COVID-19 survivors exhibited poorer performance in various neuropsychiatric domains during the acute phase, with the exception of cognitive impairment. A significant amelioration of emotional symptoms, including anxiety and depression, was observed from the acute to chronic phase among COVID-19 survivors, reaching levels comparable to those of HCs. However, at 3 months post-infection, survivors continued to report higher levels of fatigue and poorer sleep quality compared to HCs, although the differences had diminished from the acute phase. The impact of the pandemic event persisted, and no significant changes in cognitive performance were observed. Acute-phase fatigue was associated with poorer sleep and worse emotional problems during the recovery process (from the acute to the chronic phase), and further exacerbated overall HRQoL at 3 months post-infection (EQ index score, p = 0.001, Cohen's d = -0.33; EQ-VAS, p = 0.007, Cohen's d = -0.19). Conclusions Our findings provide novel evidence on the distinct temporal trajectories for post-acute COVID-19 sequelae in a longitudinal study, highlighting the negative impact of acute-phase fatigue on the process of neuropsychiatric recovery and long-term HRQoL.https://doi.org/10.1186/s12955-025-02384-wCOVID-19TrajectoryPost-viral fatigueNeuropsychiatric symptomsNeurocognitive impairmentQuality of life |
| spellingShingle | Qiange Zhu Xingpu Quan Zhaoyao Luo Yu Shang Xinyi Zhu Wenrui Bao Meiling Shang Peng Li Fan Gao Wenyang Wang Ziyi Liu Xuan Niu Yuchen Zhang The association of post-COVID-19 fatigue in the acute phase with neuropsychiatric and neurocognitive symptoms trajectory over time and long-term health-related quality of life among Chinese adults Health and Quality of Life Outcomes COVID-19 Trajectory Post-viral fatigue Neuropsychiatric symptoms Neurocognitive impairment Quality of life |
| title | The association of post-COVID-19 fatigue in the acute phase with neuropsychiatric and neurocognitive symptoms trajectory over time and long-term health-related quality of life among Chinese adults |
| title_full | The association of post-COVID-19 fatigue in the acute phase with neuropsychiatric and neurocognitive symptoms trajectory over time and long-term health-related quality of life among Chinese adults |
| title_fullStr | The association of post-COVID-19 fatigue in the acute phase with neuropsychiatric and neurocognitive symptoms trajectory over time and long-term health-related quality of life among Chinese adults |
| title_full_unstemmed | The association of post-COVID-19 fatigue in the acute phase with neuropsychiatric and neurocognitive symptoms trajectory over time and long-term health-related quality of life among Chinese adults |
| title_short | The association of post-COVID-19 fatigue in the acute phase with neuropsychiatric and neurocognitive symptoms trajectory over time and long-term health-related quality of life among Chinese adults |
| title_sort | association of post covid 19 fatigue in the acute phase with neuropsychiatric and neurocognitive symptoms trajectory over time and long term health related quality of life among chinese adults |
| topic | COVID-19 Trajectory Post-viral fatigue Neuropsychiatric symptoms Neurocognitive impairment Quality of life |
| url | https://doi.org/10.1186/s12955-025-02384-w |
| work_keys_str_mv | AT qiangezhu theassociationofpostcovid19fatigueintheacutephasewithneuropsychiatricandneurocognitivesymptomstrajectoryovertimeandlongtermhealthrelatedqualityoflifeamongchineseadults AT xingpuquan theassociationofpostcovid19fatigueintheacutephasewithneuropsychiatricandneurocognitivesymptomstrajectoryovertimeandlongtermhealthrelatedqualityoflifeamongchineseadults AT zhaoyaoluo theassociationofpostcovid19fatigueintheacutephasewithneuropsychiatricandneurocognitivesymptomstrajectoryovertimeandlongtermhealthrelatedqualityoflifeamongchineseadults AT yushang theassociationofpostcovid19fatigueintheacutephasewithneuropsychiatricandneurocognitivesymptomstrajectoryovertimeandlongtermhealthrelatedqualityoflifeamongchineseadults AT xinyizhu theassociationofpostcovid19fatigueintheacutephasewithneuropsychiatricandneurocognitivesymptomstrajectoryovertimeandlongtermhealthrelatedqualityoflifeamongchineseadults AT wenruibao theassociationofpostcovid19fatigueintheacutephasewithneuropsychiatricandneurocognitivesymptomstrajectoryovertimeandlongtermhealthrelatedqualityoflifeamongchineseadults AT meilingshang theassociationofpostcovid19fatigueintheacutephasewithneuropsychiatricandneurocognitivesymptomstrajectoryovertimeandlongtermhealthrelatedqualityoflifeamongchineseadults AT pengli theassociationofpostcovid19fatigueintheacutephasewithneuropsychiatricandneurocognitivesymptomstrajectoryovertimeandlongtermhealthrelatedqualityoflifeamongchineseadults AT fangao theassociationofpostcovid19fatigueintheacutephasewithneuropsychiatricandneurocognitivesymptomstrajectoryovertimeandlongtermhealthrelatedqualityoflifeamongchineseadults AT wenyangwang theassociationofpostcovid19fatigueintheacutephasewithneuropsychiatricandneurocognitivesymptomstrajectoryovertimeandlongtermhealthrelatedqualityoflifeamongchineseadults AT ziyiliu theassociationofpostcovid19fatigueintheacutephasewithneuropsychiatricandneurocognitivesymptomstrajectoryovertimeandlongtermhealthrelatedqualityoflifeamongchineseadults AT xuanniu theassociationofpostcovid19fatigueintheacutephasewithneuropsychiatricandneurocognitivesymptomstrajectoryovertimeandlongtermhealthrelatedqualityoflifeamongchineseadults AT yuchenzhang theassociationofpostcovid19fatigueintheacutephasewithneuropsychiatricandneurocognitivesymptomstrajectoryovertimeandlongtermhealthrelatedqualityoflifeamongchineseadults AT qiangezhu associationofpostcovid19fatigueintheacutephasewithneuropsychiatricandneurocognitivesymptomstrajectoryovertimeandlongtermhealthrelatedqualityoflifeamongchineseadults AT xingpuquan associationofpostcovid19fatigueintheacutephasewithneuropsychiatricandneurocognitivesymptomstrajectoryovertimeandlongtermhealthrelatedqualityoflifeamongchineseadults AT zhaoyaoluo associationofpostcovid19fatigueintheacutephasewithneuropsychiatricandneurocognitivesymptomstrajectoryovertimeandlongtermhealthrelatedqualityoflifeamongchineseadults AT yushang associationofpostcovid19fatigueintheacutephasewithneuropsychiatricandneurocognitivesymptomstrajectoryovertimeandlongtermhealthrelatedqualityoflifeamongchineseadults AT xinyizhu associationofpostcovid19fatigueintheacutephasewithneuropsychiatricandneurocognitivesymptomstrajectoryovertimeandlongtermhealthrelatedqualityoflifeamongchineseadults AT wenruibao associationofpostcovid19fatigueintheacutephasewithneuropsychiatricandneurocognitivesymptomstrajectoryovertimeandlongtermhealthrelatedqualityoflifeamongchineseadults AT meilingshang associationofpostcovid19fatigueintheacutephasewithneuropsychiatricandneurocognitivesymptomstrajectoryovertimeandlongtermhealthrelatedqualityoflifeamongchineseadults AT pengli associationofpostcovid19fatigueintheacutephasewithneuropsychiatricandneurocognitivesymptomstrajectoryovertimeandlongtermhealthrelatedqualityoflifeamongchineseadults AT fangao associationofpostcovid19fatigueintheacutephasewithneuropsychiatricandneurocognitivesymptomstrajectoryovertimeandlongtermhealthrelatedqualityoflifeamongchineseadults AT wenyangwang associationofpostcovid19fatigueintheacutephasewithneuropsychiatricandneurocognitivesymptomstrajectoryovertimeandlongtermhealthrelatedqualityoflifeamongchineseadults AT ziyiliu associationofpostcovid19fatigueintheacutephasewithneuropsychiatricandneurocognitivesymptomstrajectoryovertimeandlongtermhealthrelatedqualityoflifeamongchineseadults AT xuanniu associationofpostcovid19fatigueintheacutephasewithneuropsychiatricandneurocognitivesymptomstrajectoryovertimeandlongtermhealthrelatedqualityoflifeamongchineseadults AT yuchenzhang associationofpostcovid19fatigueintheacutephasewithneuropsychiatricandneurocognitivesymptomstrajectoryovertimeandlongtermhealthrelatedqualityoflifeamongchineseadults |