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Acupoint Application as a Traditional Chinese Medicine Treatment for Fatigue Associated with Chronic Obstructive Pulmonary Disease

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Post-COVID Fatigue Is Associated With Reduced Cortical Thickness After Hospitalization.

Tim J Hartung¹, Florentin Steigerwald¹, Amy Romanello^1,2

¹Department of Neurology and Experimental Neurology, Charité-Universitätsmedizin Berlin, Berlin, Germany.

Annals of Clinical and Translational Neurology

|November 25, 2025

Summary

Hospitalization for COVID-19 can cause lasting brain changes, including reduced cortical thickness and hippocampal volume. These structural brain alterations are linked to disease severity and persistent fatigue in patients.

Keywords:

COVID‐19 cognitive dysfunction fatigue magnetic resonance imaging post‐acute COVID‐19 syndrome

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Area of Science:

Neuroscience
Radiology
Infectious Diseases

Background:

Neuropsychiatric symptoms are common after COVID-19.
Brain structure changes have been observed in COVID-19 patients.
The link between brain changes and post-COVID fatigue/cognitive deficits is unclear.

Purpose of the Study:

To assess structural brain changes after COVID-19 hospitalization.
To investigate associations between brain changes, cognitive performance, and fatigue.

Main Methods:

Analyzed MRI data from 57 COVID-19 survivors and 57 healthy controls.
Assessed cortical thickness and subcortical volumes using high-resolution T1-weighted MRI.
Correlated brain metrics with cognitive (MoCA) and fatigue (FSS) scores.

Main Results:

COVID-19 patients showed reduced cortical thickness (parahippocampal gyri, temporal lobe) and hippocampal volumes.
Greater acute COVID-19 severity correlated with reduced cortical thickness, especially in the olfactory system.
Reduced cortical thickness in temporal poles and cingulate gyrus linked to higher fatigue levels.

Conclusions:

Long-lasting macrostructural brain changes occur after moderate to severe COVID-19.
These brain changes correlate with acute disease severity and long-term fatigue.
Early identification and intervention are crucial for patients at risk of persistent brain changes.