{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:00:30Z","timestamp":1753891230860,"version":"3.41.2"},"reference-count":96,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T00:00:00Z","timestamp":1747785600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Previous studies have analyzed symptom clusters in patients with coronavirus disease 2019 (COVID-19); however, evidence regarding the core symptom clusters and their influencing factors in patients with post-COVID-19 pulmonary fibrosis (PCPF) remains unclear, affecting the precision of symptom interventions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>This study aimed to identify the symptom clusters and core symptom clusters in patients with PCPF. Demographic and disease-related factors associated with these symptom clusters were also analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 350 patients with PCPF were recruited from China between January 2023 and April 2024. A self-reported symptom assessment scale was used for this survey. Principal component analysis was used to identify symptom clusters. Network analysis was used to describe the relationships between the symptoms and symptom clusters. Multiple linear models were used to analyze the factors affecting the total symptom severity and each symptom cluster.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Six symptom clusters were identified: Upper Respiratory Tract Symptom Cluster (USC), Lower Respiratory Tract Symptom Cluster (LSC), Somatic Symptom Cluster (SSC), Muscular and Joint Symptom Cluster (MSC), Neurological and Psychological Symptom Cluster (NSC), and Digestive Symptom Cluster (DSC). Fatigue was identified as the core and bridge symptom in the symptom network, whereas the upper respiratory symptom cluster was identified as the core and bridge symptom cluster. Gender, age, educational level, smoking history, and primary caregiver were associated with the scores of the six symptom clusters.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our study suggests that there is a need to evaluate symptom clusters for the improvement of symptom management among PCPF. Specifically, the assessment and treatment of upper respiratory and fatigue symptoms as core targets of PCPF care is critical for the development of accurate and efficient symptom management strategies.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2025.1538708","type":"journal-article","created":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T04:14:25Z","timestamp":1747800865000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Identifying central symptom clusters and correlates among post-COVID-19 pulmonary fibrosis patients: a network analysis"],"prefix":"10.3389","volume":"12","author":[{"given":"Zhen","family":"Yang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhiqin","family":"Xie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zequan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linxia","family":"Yi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shihan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yunyu","family":"Du","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xuemei","family":"Tao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chao","family":"Xie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chaozhu","family":"He","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,5,21]]},"reference":[{"key":"B1","unstructured":"dashboard\n              WC-\n            \n          \n          Number of COVID-19 cases reported to WHO\n          \n          2024"},{"key":"B2","unstructured":"CfDCa\n          \n          \n          COVID-19 mortality update\u2014United States, 2022\n          \n          2023"},{"key":"B3","doi-asserted-by":"publisher","first-page":"2629","DOI":"10.3390\/v14122629","article-title":"Long-COVID symptoms in individuals infected with different SARS-CoV-2 variants of concern: a systematic review of the literature","volume":"14","author":"Fern\u00e1ndez-de-Las-Pe\u00f1as","year":"2022","journal-title":"Viruses"},{"key":"B4","doi-asserted-by":"publisher","first-page":"12422","DOI":"10.3390\/ijerph191912422","article-title":"Effect of COVID-19 vaccines on reducing the risk of long COVID in the real world: a systematic review and meta-analysis","volume":"19","author":"Gao","year":"2022","journal-title":"Int J Environ Res Public Health."},{"key":"B5","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1016\/j.ajic.2021.10.039","article-title":"Clinical characteristics and symptom duration among outpatients with COVID-19","volume":"50","author":"Lane","year":"2022","journal-title":"Am J Infect Control."},{"key":"B6","doi-asserted-by":"publisher","first-page":"m3489","DOI":"10.1136\/bmj.m3489","article-title":"Long covid: how to define it and how to manage it","volume":"370","author":"Nabavi","year":"2020","journal-title":"BMJ."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1616","DOI":"10.1038\/s41590-023-01601-2","article-title":"SARS-CoV-2 reservoir in post-acute sequelae of COVID-19 (PASC)","volume":"24","author":"Proal","year":"2023","journal-title":"Nat Immunol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"320","DOI":"10.4046\/trd.2022.0053","article-title":"Post-coronavirus disease 2019 pulmonary fibrosis: wait or needs intervention","volume":"85","author":"Yoon","year":"2022","journal-title":"Tuberc Respir Dis (Seoul)."},{"key":"B9","doi-asserted-by":"publisher","first-page":"103590","DOI":"10.1016\/j.amsu.2022.103590","article-title":"Post COVID-19 pulmonary fibrosis; 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