Cognitive, psychological, and physical functioning in patients with post- COVID-19 syndrome: a study protocol for data-driven phenotyping

Abstract

Post COVID-19 Syndrome (PCS) describes individuals experiencing persistent symptoms after acute infection of SARS-Cov-2 virus. It is characterized by heterogeneous and persistent symptoms like fatigue, cognitive difficulties, and breathlessness. The illness severely impacts quality of life, complicates treatment, and induces high socioeconomic costs. While clinically relevant, most studies rely only on self-reported symptoms and functioning which insufficiently explains functioning and underlying mechanisms. The current study aims to investigate symptomatology profiles of PCS through data-driven subgrouping. To do this, in-person physical and cognitive functioning are assessed in addition to surveys. Participants (n=69) are recruited based on the WHO definition of PCS and baseline questionnaires about demographics, fatigue, symptom burden and functional status are completed before participating in two separate sessions. Session 1 involves physical testing (grip strength, CO₂ measurements, six-minute walking test) and assessment of the autonomic nervous system by stress reactivity tasks. Afterwards, over a 7-day interval, participants’ activity levels are measured using actigraphy to assess active and sedentary behavior. Additionally, questionnaires about symptom experience and global functioning are completed. Session 2 includes a measurement of psychological factors through a semi-structured interview and lastly global cognitive functioning is assessed (MoCA, MESSY). The main outcome measures are physical and cognitive functioning and clinical symptoms A cluster analysis will be conducted to identify symptom groups. With the results of this study we aim to contribute to the development of strategies for individualised treatment and generate a better understanding of the symptomatology of PCS.