Evidence map›Paper›PMID 40450337›Full record

ArticleHealth and quality of life outcomes2025

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.

Qiange Zhu, Xingpu Quan, Zhaoyao Luo, Yu Shang, Xinyi Zhu, Wenrui Bao, Meiling Shang, Peng Li, Fan Gao, Wenyang Wang and 3 more

Abstract readMulticenter Study
In one paragraph

Article in Health and quality of life outcomes, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Qiange ZhuDepartment of Medical Imaging, the First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi Province, 710061, China.
Xingpu QuanDepartment of Medical Imaging, the First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi Province, 710061, China.
Zhaoyao LuoDepartment of Medical Imaging, the First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi Province, 710061, China.
Yu ShangSchool of Future Technology, Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.
Xinyi ZhuDepartment of Medical Imaging, the First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi Province, 710061, China.
Wenrui BaoSchool of Future Technology, Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.
Meiling ShangSchool of Future Technology, Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.
Peng LiDepartment of Radiology, the Second Hospital of the Air Force Medical University, Xi'an, Shaanxi Province, China.
Fan GaoDepartment of Clinical Research Centre, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.
Wenyang WangDepartment of Medical Imaging, the First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi Province, 710061, China.
Ziyi LiuHealth Science Center, Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.
Xuan NiuDepartment of Medical Imaging, the First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi Province, 710061, China. niuxuan@xjtu.edu.cn.ORCID http://orcid.org/0000-0002-1580-0209
Yuchen ZhangDepartment of Nuclear Medicine, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China. zhangyc415@xjtu.edu.cn.

Funding

Fundamental Research Funds for the Central Universities in Xi'an Jiaotong University xzy012023128Fundamental Research Funds for the Central Universities in Xi'an Jiaotong University xzy022023078Health Research and Innovation Capacity Strengthening Platform Program of Shaanxi Province 2023PT-09Key Research and Development Plan of Xianyang City L2023-ZDYF-SF-035the National Natural Science Foundation of China 82202121the Science and Technology Research Project of Shaanxi Nuclear Industry Group Co., Ltd 61240302
6 · The paper itself

Abstract

backgroundPost-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.

methodsA 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.

resultsThree 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).

conclusionsOur 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.

Indexed as

COVID-19FatigueQuality of LifeAdultAnxietyChinaDepressionEast Asian PeopleFemaleHumansLongitudinal StudiesMaleMiddle AgedNeuropsychological TestsPost-Acute COVID-19 SyndromeProspective StudiesCOVID-19Linear mixed modelsNeurocognitive impairmentNeuropsychiatric symptomsPost-viral fatigueQuality of lifeTrajectory

Identifiers

PMID40450337
PMCPMC12125754

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.