Elevated central sensitization inventory scores are associated with a multidimensional symptom profile after coronavirus disease 2019

Post-COVID-19 condition comprises persistent heterogeneous symptoms, and central sensitization-related manifestations may overlap with neurocognitive, autonomic, affective, and functional complaints. This cross-sectional study examined associations between Central Sensitization Inventory (CSI) scores ≥ 40 and persistent clinical manifestations in 153 adults with symptoms after self-reported COVID-19 who attended an outpatient clinic in southern Brazil during 2021–2022. Anxiety, depressive symptoms, sleep quality, functional status, and post-COVID-19 symptoms were assessed. Robust Poisson regression estimated prevalence ratios adjusted for age, sex, education, smoking, body mass index, hypertension and diabetes reported after COVID-19, and hospitalization during acute infection. CSI scores ≥ 40 were observed in 56.2% of participants. In fully adjusted exposure-specific models, elevated CSI scores were associated with brain fog (PR = 1.712; 95% CI 1.185–2.473; p = 0.004), abdominal pain (PR = 1.768; 95% CI 1.206–2.592; p = 0.003), exercise intolerance (PR = 1.533; 95% CI 1.112–2.113; p = 0.009), depressive symptoms (PR = 1.246; 95% CI 1.097–1.416; p = 0.001), and functional limitations (PR = 1.180; 95% CI 1.019–1.368; p = 0.027). Elevated CSI scores were therefore associated with a broad post-COVID-19 symptom profile, although longitudinal studies are needed to clarify temporal direction and determine whether these associations persist across different clinical populations.