Increased breathlessness in post-COVID syndrome despite normal breathing patterns in a rebreathing challenge
Abstract Severe symptoms in the absence of measurable body pathology are a frequent hallmark of post-COVID syndrome. From a Bayesian Brain perspective, such symptoms can be explained by incorrect internal models that the brain uses to interpret sensory signals. In this pre-registered study, we inves...
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Nature Portfolio
2025-07-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-025-11728-x |
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| author | Dina von Werder Maria Aubele Franziska Regnath Elisabeth Tebbe Dejan Mladenov Victoria von Rheinbaben Elisabeth Hahn Daniel Schäfer Katharina Biersack Kristina Adorjan Hans C. Stubbe Katleen Bogaerts Rudolf A. Jörres Dennis Nowak Omer Van den Bergh Stefan Glasauer Nadine Lehnen |
| author_facet | Dina von Werder Maria Aubele Franziska Regnath Elisabeth Tebbe Dejan Mladenov Victoria von Rheinbaben Elisabeth Hahn Daniel Schäfer Katharina Biersack Kristina Adorjan Hans C. Stubbe Katleen Bogaerts Rudolf A. Jörres Dennis Nowak Omer Van den Bergh Stefan Glasauer Nadine Lehnen |
| author_sort | Dina von Werder |
| collection | DOAJ |
| description | Abstract Severe symptoms in the absence of measurable body pathology are a frequent hallmark of post-COVID syndrome. From a Bayesian Brain perspective, such symptoms can be explained by incorrect internal models that the brain uses to interpret sensory signals. In this pre-registered study, we investigate whether induced breathlessness perception during a controlled CO2rebreathing challenge is reflected by altered respiratory measures (physiology and breathing patterns), and propose different computational mechanisms that could explain our findings in a Bayesian Brain framework. We analysed data from 40 patients with post-COVID syndrome and 40 healthy participants. Results from lung function, neurological and neurocognitive examination of all participants were within normal limits on the day of the experiment. Using a Bayesian repeated-measures ANOVA, we found that patients’ breathlessness was strongly increased (BF10,baseline =8.029, BF10,rebreathing =11636, BF10,recovery =43662) compared to controls. When excluding patients who hyperventilated (N = 8, 20%) during the experiment from the analysis, differences in breathlessness remained (BF10,baseline =1.283, BF10,rebreathing =126.812, BF10,recovery =751.282). For physiology and breathing patterns, all evidence pointed towards no difference between the two groups (0.307 > BF10 < 0.704). In summary, we found intact breathing patterns and physiology but increased symptom perception in patients with post-COVID syndrome. |
| format | Article |
| id | doaj-art-fecc93ac0db543f0b6cfaf480f67dd02 |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Nature Portfolio |
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| series | Scientific Reports |
| spelling | doaj-art-fecc93ac0db543f0b6cfaf480f67dd022025-08-20T03:42:31ZengNature PortfolioScientific Reports2045-23222025-07-0115111510.1038/s41598-025-11728-xIncreased breathlessness in post-COVID syndrome despite normal breathing patterns in a rebreathing challengeDina von Werder0Maria Aubele1Franziska Regnath2Elisabeth Tebbe3Dejan Mladenov4Victoria von Rheinbaben5Elisabeth Hahn6Daniel Schäfer7Katharina Biersack8Kristina Adorjan9Hans C. Stubbe10Katleen Bogaerts11Rudolf A. Jörres12Dennis Nowak13Omer Van den Bergh14Stefan Glasauer15Nadine Lehnen16Institute of Medical Technology, Brandenburg University of Technology Cottbus- SenftenbergDepartment of Psychosomatic Medicine and Psychotherapy, TUM University Hospital, Technical University MunichDepartment of Psychosomatic Medicine and Psychotherapy, TUM University Hospital, Technical University MunichDepartment of Psychosomatic Medicine and Psychotherapy, TUM University Hospital, Technical University MunichDepartment of Psychosomatic Medicine and Psychotherapy, TUM University Hospital, Technical University MunichDepartment of Psychosomatic Medicine and Psychotherapy, TUM University Hospital, Technical University MunichDepartment of Psychosomatic Medicine and Psychotherapy, TUM University Hospital, Technical University MunichDepartment of Psychosomatic Medicine and Psychotherapy, TUM University Hospital, Technical University MunichDepartment of Psychosomatic Medicine and Psychotherapy, TUM University Hospital, Technical University MunichUniversity Hospital of Psychiatry and Psychotherapy, University of BernDepartment of Medicine II, LMU University Hospital, LMU MunichREVAL – Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt UniversityInstitute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMUInstitute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMUREVAL – Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt UniversityInstitute of Medical Technology, Brandenburg University of Technology Cottbus- SenftenbergGraduate School of Systemic Neurosciences, Ludwig-Maximilians-Universität MünchenAbstract Severe symptoms in the absence of measurable body pathology are a frequent hallmark of post-COVID syndrome. From a Bayesian Brain perspective, such symptoms can be explained by incorrect internal models that the brain uses to interpret sensory signals. In this pre-registered study, we investigate whether induced breathlessness perception during a controlled CO2rebreathing challenge is reflected by altered respiratory measures (physiology and breathing patterns), and propose different computational mechanisms that could explain our findings in a Bayesian Brain framework. We analysed data from 40 patients with post-COVID syndrome and 40 healthy participants. Results from lung function, neurological and neurocognitive examination of all participants were within normal limits on the day of the experiment. Using a Bayesian repeated-measures ANOVA, we found that patients’ breathlessness was strongly increased (BF10,baseline =8.029, BF10,rebreathing =11636, BF10,recovery =43662) compared to controls. When excluding patients who hyperventilated (N = 8, 20%) during the experiment from the analysis, differences in breathlessness remained (BF10,baseline =1.283, BF10,rebreathing =126.812, BF10,recovery =751.282). For physiology and breathing patterns, all evidence pointed towards no difference between the two groups (0.307 > BF10 < 0.704). In summary, we found intact breathing patterns and physiology but increased symptom perception in patients with post-COVID syndrome.https://doi.org/10.1038/s41598-025-11728-x |
| spellingShingle | Dina von Werder Maria Aubele Franziska Regnath Elisabeth Tebbe Dejan Mladenov Victoria von Rheinbaben Elisabeth Hahn Daniel Schäfer Katharina Biersack Kristina Adorjan Hans C. Stubbe Katleen Bogaerts Rudolf A. Jörres Dennis Nowak Omer Van den Bergh Stefan Glasauer Nadine Lehnen Increased breathlessness in post-COVID syndrome despite normal breathing patterns in a rebreathing challenge Scientific Reports |
| title | Increased breathlessness in post-COVID syndrome despite normal breathing patterns in a rebreathing challenge |
| title_full | Increased breathlessness in post-COVID syndrome despite normal breathing patterns in a rebreathing challenge |
| title_fullStr | Increased breathlessness in post-COVID syndrome despite normal breathing patterns in a rebreathing challenge |
| title_full_unstemmed | Increased breathlessness in post-COVID syndrome despite normal breathing patterns in a rebreathing challenge |
| title_short | Increased breathlessness in post-COVID syndrome despite normal breathing patterns in a rebreathing challenge |
| title_sort | increased breathlessness in post covid syndrome despite normal breathing patterns in a rebreathing challenge |
| url | https://doi.org/10.1038/s41598-025-11728-x |
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