Evidence map›Paper›PMID 41737723›Full record

ArticleBrain, behavior, & immunity - health2026

Acute inflammation and fronto-striatal connectivity in the transition from acute to persistent fatigue after mild COVID-19: A longitudinal fMRI study.

Qiange Zhu, Tao Lu, Huijie Yuan, Ya'nan Zhu, Pang Du, Haiyang Liu, Baoqi Wang, Tonghui Liu, Bo Wang, Yi Chen and 5 more

Abstract read
In one paragraph

Article in Brain, behavior, & immunity - health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

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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

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

15 authors.

Qiange ZhuDepartment of Medical Imaging, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.
Tao LuDepartment of Medical Imaging, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.
Huijie YuanDepartment of Medical Imaging, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.
Ya'nan ZhuMedical Imaging Centre, Ankang Central Hospital, Ankang, Shaanxi Province, China.
Pang DuDepartment of Medical Imaging, Xi'an QinHuang Hospital, Xi'an, Shaanxi Province, China.
Haiyang LiuDepartment of Medical Imaging, Shangluo Central Hospital, Shangluo, Shaanxi Province, China.
Baoqi WangDepartment of Medical Imaging, Yanan Traditional Chinese Medicine Hospital, Yan'an, Shaanxi Province, China.
Tonghui LiuDepartment of Medical Imaging, Nuclear Industry 215 Hospital of Shaanxi Province, Xianyang, Shaanxi Province, China.
Bo WangDepartment of Medical Imaging, Hanzhong Central Hospital, Hanzhong, Shaanxi Province, China.
Yi ChenDepartment of Magnetic Resonance Imaging, Yulin Hospital, The First Affiliated Hospital of Xi'an Jiaotong University, Yulin, Shaanxi Province, China.
Hui MaDepartment of Medical Imaging, Baoji High-tech Hospital, Baoji, Shaanxi Province, China.
Jixin LiuSchool of Life Science and Technology, Xidian University, Xi'an Key Laboratory of Intelligent Sensing and Regulation of Trans-Scale Life Information, Xi'an, Shaanxi, China.
Yang WangDepartment of Radiology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA.
Ming ZhangDepartment of Medical Imaging, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.
Xuan NiuDepartment of Medical Imaging, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Persistent fatigue is one of the most common and disabling sequelae of COVID-19, yet its neurobiological mechanisms remain poorly understood. Emerging evidence implicates systemic inflammation and fronto-striatal dysfunction in fatigue across diverse clinical conditions. However, the links between early inflammatory responses, brain connectivity, and the acute-to-chronic trajectory of post-COVID fatigue are unclear. Methods: In a multi-center longitudinal cohort of 193 young-to-middle-aged adults with mild COVID-19, we assessed acute-phase C-reactive protein (CRP), fatigue severity (FAS) at <1 month (acute, FAS-1) and 3 months (chronic, FAS-2) post-infection, and resting-state fMRI at 3 months. Functional connectivity (FC) differences between participants with persistent (n = 48) and non-persistent fatigue (n = 145) were examined, and mediation analyses were performed to evaluate pathways linking CRP, FC alterations, and fatigue progression. Results: Acute-phase CRP levels were elevated in the persistent fatigue group and positively correlated with fatigue severity at both time points. Compared with the non-persistent group, individuals with persistent fatigue showed reduced functional connectivity (FC) between the left superior frontal gyrus (SFG L) and striatal regions (caudate L and putamen L). This SFG L-striatal FC was negatively correlated with fatigue severity. Crucially, a chain mediation model suggested that the association between CRP on chronic fatigue was statistically mediated through two sequential pathways: (1) via acute fatigue alone, and (2) via acute fatigue followed by reduced SFG L-striatal FC. Conclusion: In this cohort of mild COVID-19 survivors, this study identifies acute inflammation (elevated CRP) as a significant predictor of post-COVID fatigue and suggests that reduced fronto-striatal connectivity may mediate the transition from acute to chronic fatigue. These findings highlight the fronto-striatal circuit as a potential imaging biomarker and point to the acute phase as a critical window for anti-inflammatory or neuromodulatory interventions. Further longitudinal and interventional studies are needed to validate these mechanisms and therapeutic strategies.

Indexed as

Fronto-striatal circuitFunctional connectivityInflammationMediation analysisPost-COVID fatigue

Identifiers

PMID41737723
PMCPMC12926603

What Socratic holds

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LicenceCC BY-NC-ND
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Registered trials

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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 Socratic graph.