{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T04:23:34Z","timestamp":1790051014049,"version":"4.0.1"},"reference-count":32,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T00:00:00Z","timestamp":1764028800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T00:00:00Z","timestamp":1764028800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002347","name":"Bundesministerium f\u00fcr Bildung und Forschung","doi-asserted-by":"publisher","award":["FKZ: 01KX2021"],"award-info":[{"award-number":["FKZ: 01KX2021"]}],"id":[{"id":"10.13039\/501100002347","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002347","name":"Bundesministerium f\u00fcr Bildung und Forschung","doi-asserted-by":"publisher","award":["FKZ: 01KX2121"],"award-info":[{"award-number":["FKZ: 01KX2121"]}],"id":[{"id":"10.13039\/501100002347","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Transl Neurol"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Neuropsychiatric symptoms are among the most prevalent sequelae of COVID\u201019, particularly among hospitalized patients. Recent research has identified volumetric brain changes associated with COVID\u201019. However, it currently remains poorly understood how brain changes relate to post\u2010COVID fatigue and cognitive deficits. We, therefore, aimed to assess structural brain changes after hospitalization for COVID\u201019 and their associations with cognitive performance and fatigue.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We analyzed data from\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200957 patients previously hospitalized for COVID\u201019 (63% male, mean age 52\u2009years) from the prospective, multicentric high\u2010resolution platform of the German National Pandemic Cohort Network (NAPKON\u2010HAP) and\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200957 matched healthy control participants (HC). We assessed cortical thickness and subcortical volumes in high\u2010resolution T1\u2010weighted MRI and their associations with cognitive performance (Montreal Cognitive Assessment) and fatigue (Fatigue Severity Scale).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Patients exhibited statistically significant reductions of cortical thickness in parahippocampal gyri and the temporal lobe (all\n                      <jats:italic>p<\/jats:italic>\n                      [FDR\u2010corrected] &lt;\u20090.05) as well as reduced hippocampal volumes compared to HC (left, Cohen's\n                      <jats:italic>d<\/jats:italic>\n                      [95% CI]\u2009=\u20090.50 [0.12\u20130.8]; right\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u20090.43 [0.05\u20130.80]). Higher acute COVID\u201019 severity was associated with reduced cortical thickness, particularly in the olfactory system. Furthermore, reduced cortical thickness of the temporal poles and the anterior and posterior cingulate gyrus was associated with more severe post\u2010acute fatigue.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>Our results identify long\u2010lasting macrostructural brain changes after moderate to severe COVID\u201019 that correlate with acute disease severity and long\u2010term fatigue. Early identification and targeted interventions for patients at risk of persistent brain changes are needed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>\n                      NAPKON\u2010HAP is registered at\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">clinicaltrials.gov<\/jats:ext-link>\n                      (NCT04747366)\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acn3.70260","type":"journal-article","created":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T12:31:42Z","timestamp":1764073902000},"page":"755-766","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Post\u2010\n                    <scp>COVID<\/scp>\n                    Fatigue Is Associated With Reduced Cortical Thickness After Hospitalization"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5929-4643","authenticated-orcid":false,"given":"Tim J.","family":"Hartung","sequence":"first","affiliation":[{"name":"Department of Neurology and Experimental Neurology Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florentin","family":"Steigerwald","sequence":"additional","affiliation":[{"name":"Department of Neurology and Experimental Neurology Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Romanello","sequence":"additional","affiliation":[{"name":"Department of Neurology and Experimental Neurology Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin  Berlin Germany"},{"name":"Berlin School of Mind and Brain Humboldt\u2010Universit\u00e4t zu Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cathrin","family":"Kodde","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, Respiratory Medicine and Critical Care Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6520-3720","authenticated-orcid":false,"given":"Matthias","family":"Endres","sequence":"additional","affiliation":[{"name":"Department of Neurology and Experimental Neurology Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin  Berlin Germany"},{"name":"Center for Stroke Research Berlin  Berlin Germany"},{"name":"German Center for Mental Health (DZPG), Partner Site  Berlin Germany"},{"name":"German Center for Neurodegenerative Diseases (DZNE), Partner Site  Berlin Germany"},{"name":"German Centre for Cardiovascular Research (DZHK), partner Site  Berlin 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Hospital Cologne University of Cologne  Cologne Germany"},{"name":"Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging\u2010Associated Diseases (CECAD), Faculty of Medicine and University Hospital Cologne University of Cologne  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0683-5386","authenticated-orcid":false,"given":"Stephan","family":"Krohn","sequence":"additional","affiliation":[{"name":"Department of Neurology and Experimental Neurology Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin  Berlin Germany"},{"name":"Berlin School of Mind and Brain Humboldt\u2010Universit\u00e4t zu Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Pape","sequence":"additional","affiliation":[{"name":"Department I of Internal Medicine University Medical Center Schleswig\u2010Holstein  Kiel 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