{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T18:29:11Z","timestamp":1754159351572,"version":"3.41.2"},"reference-count":32,"publisher":"Royal College of Psychiatrists","issue":"4","license":[{"start":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T00:00:00Z","timestamp":1753401600000},"content-version":"unspecified","delay-in-days":24,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["BJPsych open"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec id=\"S2056472425100781_as1\">\n\t    <jats:title>Background<\/jats:title>\n\t    <jats:p>The heterogeneity of chronic post-COVID neuropsychiatric symptoms (PCNPS), especially after infection by the Omicron strain, has not been adequately explored.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472425100781_as2\">\n\t    <jats:title>Aims<\/jats:title>\n\t    <jats:p>To explore the clustering pattern of chronic PCNPS in a cohort of patients having their first COVID infection during the \u2018Omicron wave\u2019 and discover phenotypes of patients based on their symptoms\u2019 patterns using a pre-registered protocol.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472425100781_as3\">\n\t    <jats:title>Method<\/jats:title>\n\t    <jats:p>We assessed 1205 eligible subjects in Hong Kong using app-based questionnaires and cognitive tasks.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472425100781_as4\">\n\t    <jats:title>Results<\/jats:title>\n\t    <jats:p>Partial network analysis of chronic PCNPS in this cohort produced two major symptom clusters (cognitive complaint\u2013fatigue and anxiety\u2013depression) and a minor headache\u2013dizziness cluster, like our pre-Omicron cohort. Participants with high numbers of symptoms could be further grouped into two distinct phenotypes: a cognitive complaint\u2013fatigue predominant phenotype and another with symptoms across multiple clusters. Multiple logistic regression showed that both phenotypes were predicted by the level of pre-infection deprivation (adjusted <jats:italic>P<\/jats:italic>-values of 0.025 and 0.0054, respectively). The severity of acute COVID (adjusted <jats:italic>P<\/jats:italic> = 0.023) and the number of pre-existing medical conditions predicted only the cognitive complaint\u2013fatigue predominant phenotype (adjusted <jats:italic>P<\/jats:italic> = 0.003), and past suicidal ideas predicted only the symptoms across multiple clusters phenotype (adjusted <jats:italic>P<\/jats:italic> &lt; 0.001). Pre-infection vaccination status did not predict either phenotype.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472425100781_as5\">\n\t    <jats:title>Conclusions<\/jats:title>\n\t    <jats:p>Our findings suggest that we should pursue a phenotype-driven approach with holistic biopsychosocial perspectives in disentangling the heterogeneity under the umbrella of chronic PCNPS. Management of patients complaining of chronic PCNPS should be stratified according to their phenotypes. Clinicians should recognise that depression and anxiety cannot explain all chronic post-COVID cognitive symptoms.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1192\/bjo.2025.10078","type":"journal-article","created":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T07:49:58Z","timestamp":1750405798000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Chronic post-COVID neuropsychiatric symptoms persisting more than 1 year after infection during the \u2018Omicron wave\u2019"],"prefix":"10.1192","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2986-8677","authenticated-orcid":false,"given":"Steven Wai Ho","family":"Chau","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy Mitchell","family":"Chue","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsz Ching","family":"Lam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1002-8805","authenticated-orcid":false,"given":"Yee Lok","family":"Lai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel Ngan Yin","family":"Chan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3388-6285","authenticated-orcid":false,"given":"Paul W. C.","family":"Wong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shirley Xin","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yaping","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2692-2666","authenticated-orcid":false,"given":"Joey Wing Yan","family":"Chan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul Kay-sheung","family":"Chan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher Koon-Chi","family":"Lai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas W. 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Published by Cambridge University Press on behalf of Royal College of Psychiatrists","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e160"}}