Publication date: Jan 27, 2025

A significant proportion of patients who have recovered from COVID-19 suffer from persistent symptoms, referred to as “post-acute sequelae of SARS-CoV-2 infection (PASC)”. Abnormal brain intrinsic activity has been observed in PASC patients, but the patterns of frequency-dependent intrinsic activity in the PASC and non-PASC (recovered COVID-19 patients without persistent symptoms) groups and their association with neuropsychiatric sequelae remain unclear in PASC. Twenty-nine PASC patients, 27 non-PASC subjects, and 31 healthy controls (HCs) were recruited. The voxel-level fractional amplitude of low-frequency fluctuation (fALFF) was calculated in different frequency bands (typical frequency band: 0. 01-0. 10 Hz; slow 5: 0. 01-0. 023 Hz; slow 4: 0. 023-0. 073 Hz) to assess regional intrinsic activity patterns within different groups. Correlation analyses were performed to explore the associations between frequency-dependent alterations and clinical variables. Significant frequency-dependent alterations in intrinsic activity patterns were observed in both the PASC and non-PASC groups, primarily involving regions of the default mode network (DMN). The decreased fALFF values of the DMN in different frequency bands were associated with different symptoms in PASC. For example, decreased fALFF in the left precuneus in the typical frequency band was related to general attention impairment in PASC, whereas decreased fALFF in the left superior frontal gyrus appeared in non-PASC. The fALFF alterations in the left precuneus/posterior cingulate gyrus in the slow 5 band were also related to cognitive performance in PASC. Additionally, in the slow 4 band, decreased fALFF in the right angular gyrus was associated with depressive symptoms in the PASC. Our results may provide insights into the potential neural mechanisms underlying symptoms in PASC patients.

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