Higher CRP levels are related to increased grey matter volume in anterior cingulate cortex and fatigue symptom in COVID-19 survivors in acute phase

Motivation: Post-COVID fatigue likely involves the cingulate cortex via neuroinflammatory mechanisms, but the impact of COVID-19 on CC volume through inflammation is still unknown. Goal(s): Therefore, this study investigated the relationship between immune biomarkers and the subregion of CC, neuropsychiatric symptoms in early post-COVID-19 patients. Approach: The subregions of CC were measured using Freesurfer, then analyzed the association between CC subregions, peripheral CRP and neuropsychiatric assessments. Results: In post-COVID-19 fatigue patients, the anterior CC (ACC) volume increased in high CRP cases compared to low CRP group. Additionally, higher CRP level and larger ACC volume were associated with more severe fatigue symptoms. Impact: This study provides direct evidence of an association between immune biomarkers, ACC, and fatigue symptoms. These results point towards a putative etiological model of post-COVID-19 fatigue, in which elevated peripheral proteins are associated with structural changes in the ACC.