{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T05:46:14Z","timestamp":1790660774410,"version":"4.1.0"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,2,21]],"date-time":"2024-02-21T00:00:00Z","timestamp":1708473600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,2,21]],"date-time":"2024-02-21T00:00:00Z","timestamp":1708473600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Transl Med"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>In the Netherlands, the prevalence of post COVID-19 condition is estimated at 12.7% at 90\u2013150\u00a0days after SARS-CoV-2 infection. This study aimed to determine the occurrence of fatigue and other symptoms, to assess how many patients meet the Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome (ME\/CFS) criteria, to identify symptom-based clusters within the P4O2 COVID-19 cohort and to compare these clusters with clusters in a ME\/CFS cohort.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>In this multicentre,\u00a0prospective, observational cohort in the Netherlands, 95 post COVID-19 patients aged 40\u201365\u00a0years were included. Data collection at 3\u20136\u00a0months after infection included demographics, medical history, questionnaires, and a medical examination. Follow-up assessments occurred 9\u201312\u00a0months later, where the same data were collected. Fatigue was determined with the Fatigue Severity Scale (FSS), a score of\u2009\u2265\u20094 means moderate to high fatigue. The frequency and severity of other symptoms and the percentage of patients that meet the ME\/CFS criteria were assessed using the DePaul Symptom Questionnaire-2 (DSQ-2). A self-organizing map was used to visualize the clustering of patients based on severity and frequency of 79 symptoms. In a previous study, 337 Dutch ME\/CFS patients were clustered based on their symptom scores. The symptom scores of post COVID-19 patients were applied to these clusters to examine whether the same or different clusters were found.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>According to the FSS, fatigue was reported by 75.9% of the patients at 3\u20136\u00a0months after infection and by 57.1% of the patients 9\u201312\u00a0months later. Post-exertional malaise, sleep disturbances, pain, and neurocognitive symptoms were also frequently reported, according to the DSQ-2. Over half of the patients (52.7%) met the Fukuda criteria for ME\/CFS, while fewer patients met other ME\/CFS definitions. Clustering revealed specific symptom patterns and showed that post COVID-19 patients occurred in 11 of the clusters that have been observed in the ME\/CFS cohort, where 2 clusters had\u2009&gt;\u200910 patients.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>This study shows persistent fatigue and diverse symptomatology in post COVID-19 patients, up to 12\u201318\u00a0months after SARS-CoV-2 infection. Clustering showed that post COVID-19 patients occurred in 11 of the clusters that have been observed in the ME\/CFS cohort.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12967-024-04979-1","type":"journal-article","created":{"date-parts":[[2024,2,21]],"date-time":"2024-02-21T12:03:23Z","timestamp":1708517003000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Fatigue and symptom-based clusters in post COVID-19 patients: a multicentre, prospective, observational cohort study"],"prefix":"10.1186","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-5707-4673","authenticated-orcid":false,"given":"Merel E. 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All participants gave their written informed consent.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"M.E.B.C., L.D.B., N.B., R.J.H.C.G.B., L.H., L.C.E.N. and A.H.M.: Public and private partners in the P4O2 consortium, as listed under \u2018funding\u2019. M.A.S. reports grants from Lung Foundation Netherlands, grants from Stichting Astma Bestrijding, grants and fees from Boehringer Ingelheim, and grants and personal fees from AstraZeneca, outside the submitted work. All payments were done to M.A.S. employer. S.B., A.W.V. and Q.D. declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"191"}}