ORIGINAL RESEARCH article
Front. Med.
Sec. Pulmonary Medicine
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1538708
Identifying central symptom clusters and correlates among post-COVID-19 pulmonary fibrosis patients: a network analysis
Provisionally accepted
zhen Yang1Zhiqin Xie1
Zequan Wang1Linxia Yi1Shihan Chen1Yunyu Du1Xuemei Tao1Chao Xie1Li Zhou1Wanyin Xiong1Min Zhang1
Tianxin Xiang1
chaozhu He2*- 1The First Affiliated Hospital of Nanchang University, Nanchang, China
- 2Nanchang University, Nanchang, Jiangxi Province, China
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Background: 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. Objectives: 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. Methods: 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. Results: 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), 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.Conclusion: 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.Key Words: COVID-19; pulmonary fibrosis ；Lung Diseases, Interstitial; Syndrome；Social Network Analysis
Keywords: COVID-19, Pulmonary Fibrosis, Lung Diseases, Interstitial, syndrome, social network analysis
Received: 10 Feb 2025; Accepted: 10 Apr 2025.
Copyright: © 2025 Yang, Xie, Wang, Yi, Chen, Du, Tao, Xie, Zhou, Xiong, Zhang, Xiang and He. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: chaozhu He, Nanchang University, Nanchang, 330031, Jiangxi Province, China
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