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Acta Neuropsychiatr . Lowered oxygen saturation and increased body temperature in acute COVID-19 largely predict chronic fatigue syndrome and affec

tetano

Editor, Senior Moderator
Acta Neuropsychiatr


. 2022 Sep 22;1-12.
doi: 10.1017/neu.2022.21. Online ahead of print.
Lowered oxygen saturation and increased body temperature in acute COVID-19 largely predict chronic fatigue syndrome and affective symptoms due to Long COVID: A precision nomothetic approach


Dhurgham Shihab Al-Hadrawi[SUP] 1 [/SUP], Haneen Tahseen Al-Rubaye[SUP] 2 [/SUP], Abbas F Almulla[SUP] 3 4 [/SUP], Hussein Kadhem Al-Hakeim[SUP] 5 [/SUP], Michael Maes[SUP] 4 6 7 [/SUP]



Affiliations

Abstract

Background: Long coronavirus disease 2019 (LC) is a chronic sequel of acute COVID-19. The exact pathophysiology of the affective, chronic fatigue and physiosomatic symptoms (labelled as "physio-affective phenome") of LC has remained elusive.
Objective: The current study aims to delineate the effects of oxygen saturation (SpO2) and body temperature during the acute phase on the physio-affective phenome of LC.
Method: We recruited 120 LC patients and 36 controls. For all participants, we assessed the lowest SpO2 and peak body temperature during acute COVID-19, and the Hamilton Depression and Anxiety Rating Scale (HAMD/HAMA) and Fibro Fatigue (FF) scales 3-4 months later.
Results: Lowered SpO2 and increased body temperature during the acute phase and female sex predict 60.7% of the variance in the physio-affective phenome of LC. Using unsupervised learning techniques, we were able to delineate a new endophenotype class, which comprises around 26.7% of the LC patients and is characterised by very low SpO2 and very high body temperature, and depression, anxiety, chronic fatigue, and autonomic and gastro-intestinal symptoms scores. Single latent vectors could be extracted from both biomarkers, depression, anxiety and FF symptoms or from both biomarkers, insomnia, chronic fatigue, gastro-intestinal and autonomic symptoms.
Conclusion: The newly constructed endophenotype class and pathway phenotypes indicate that the physio-affective phenome of LC is at least in part the consequence of the pathophysiology of acute COVID-19, namely the combined effects of lowered SpO2, increased body temperature and the associated immune-inflammatory processes and lung lesions.

Keywords: chronic fatigue syndrome; depression; hypoxia; inflammation; long COVID-19; neuro-immune; psychiatry.
 
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