Al-Jassas, Hawraa Kadhem, Al-Hakeim, Hussein Kadhem, Maes, Michael · Journal of affective disorders · 2022 · DOI
This study examined 60 COVID-19 patients and 30 healthy controls to understand why some people develop depression, anxiety, and fatigue-like symptoms after COVID-19 infection. The researchers found that lung damage (seen on CT scans), low oxygen levels, and an overactive immune response are connected to these mental health and fatigue symptoms. Essentially, the physical damage to the lungs may trigger immune system activation, which then leads to depression, anxiety, and fatigue.
For ME/CFS patients and researchers, this study provides a mechanistic model showing how viral infection can trigger a cascade from lung injury → immune activation → neuropsychiatric and fatigue symptoms. This connection between physical organ damage, immune dysregulation, and symptoms mirrors discussions in ME/CFS pathophysiology and suggests that post-viral fatigue syndromes may share common immunological pathways. Understanding these mechanisms could inform both acute COVID-19 management and long-term recovery strategies.
This study does not prove causation—it shows associations in a single cross-sectional snapshot. It does not establish whether these mechanisms apply specifically to ME/CFS or to long COVID; the findings are limited to acute COVID-19 patients. The study also does not clarify why some infected individuals develop these symptoms while others do not, nor does it address whether the observed immune activation is pathological or an appropriate response.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Al-Jassas, Hawraa Kadhem, Al-Hakeim, Hussein Kadhem, & Maes, Michael (2022). Intersections between pneumonia, lowered oxygen saturation percentage and immune activation mediate depression, anxiety, and chronic fatigue syndrome-like symptoms due to COVID-19: A nomothetic network approach.. Journal of affective disorders. https://doi.org/10.1016/j.jad.2021.10.039
BibTeX
@article{mecfsatlas-al-jassas-2022-intersections-between,
author = {Al-Jassas, Hawraa Kadhem and Al-Hakeim, Hussein Kadhem and Maes, Michael},
title = {Intersections between pneumonia, lowered oxygen saturation percentage and immune activation mediate depression, anxiety, and chronic fatigue syndrome-like symptoms due to COVID-19: A nomothetic network approach.},
journal = {Journal of affective disorders},
year = {2022},
doi = {10.1016/j.jad.2021.10.039},
note = {PubMed: 34699853},
url = {https://www.mecfsatlas.com/evidence/al-jassas-2022-intersections-between},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/al-jassas-2022-intersections-between
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