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COVID-19 patients may experience physical and mental symptoms long after the acute phase of the infection has passed. Accurate diagnosis of these symp-toms is needed in order to provide those affected with targeted treatments. The goal of the EPSILON project is to use interactive virtual reality (VR) technologies and sensors worn on the body to accurately characterize the most common symptoms — fatigue and cognitive deficits — to differentiate and clearly define them. The Fraunhofer HHI is coordinating the project and working closely with partners to develop VR-supported diagnostic methods to identify, record and analyze Post-COVID symptoms.
The infection is cleared, but the symptoms remain: Worldwide, millions of people suffer Post-COVID symptoms. More than 200 symptoms are now known, affecting nearly every organ in the body: heart or lungs, kidneys or gastrointestinal system, the sensory system or metabolism, muscles or brain. People with Post-COVID condition report muscle and chest pain, shortness of breath, cough, problems with memory, sleep, smell and taste or pounding heartbeat. Cognitive deficits and states of exhaustion such as fatigue syndrome are among the most common problems in those with persistent symptoms. These issues are still present more than three months after the onset of a SARS-CoV-2 infection. In addition to the individual suffering involved, this also has significant economic and social consequences for society as a whole.
Set of multimodal diagnostic tools for targeted therapy
With such a wide variety of different symptoms presenting, the requirements that apply to suitable treatment vary widely as well. In addition to accurate diagnosis, clinicians need to be able to reliably distinguish between Post-COVID and other illnesses such as depression or burnout. The researchers working on the EPSILON project (see below) are dedicated to this task. To be able to initiate targeted treatment, they are working under the coordination of Fraunhofer HHI to map out accurate and objective criteria for differentiating the top two most common symptoms of Post-COVID condition: cognitive deficits such as difficulty concentrating or memory problems and fatigue syndrome, a feeling of lasting exhaustion, tiredness and lack of drive. The project partners aim to use a set of multimodal diagnostic tools to objectively capture and describe the cognitive and vegetative state of patients with these symptoms, along with their behavior patterns. “Patients with Post-COVID symptoms feel sick, but in many cases there is no clear name for what they are experiencing. With the health data we are collecting in testing, we are developing an analytical tool to quickly and easily assess the severity of the cognitive and fatigue-related limitations involved. Patients can then consult their primary care physician or a Post-COVID clinic for targeted treatment,” says Paul Chojecki, a research scientist at Fraunhofer HHI and the coordinator of EPSILON.
To build an individualized data profile, Post-COVID patients undergo extensive pre-screenings at Post-COVID clinics and tests at the project’s participating medical centers. These examinations are supplemented by other tests during which the researchers use VR technologies with specially developed apps along with smart watches, sensors worn on the body and digitalized psychological tests. While the wearables log vital signs and sleep data, the interactive VR tools capture information on patients’ eye gaze, gestures and body movements and use the parameters detected for diagnostic purposes, such as determining and assessing levels of physical exertion. The VR tools can also be used for cognitive effort and spatial memory tests. In these three-dimensional memory tasks, patients are asked to remember and restore the correct positions of objects in space, among other things.
Pooling all research data in an interactive data space
The data gathered in this way is collected and compiled in an interactive data space developed by Fraunhofer HHI, the web-based EPSILON analysis platform, where the information is automatically analyzed using AI algorithms. The project partners aim to use this data as a basis for implementing a multimodal model for characterizing Post-COVID subtypes. The model is to visualize the results for users in real time. The analysis of the data with explanations will be available to more than just medical professionals and researchers. Plans call for giving patients access to the results as well via a visualization dashboard with a specially designed interface. The researchers hope this approach will ease the strain on Post-COVID clinics and provide valuable data for future COVID research and other applications.
The project is currently still in the data gathering phase. In the future, Chojecki and his team plan to adapt the interactive data space to research on other health conditions as well. For example, there are plans to use the analysis platform as part of the TeMoRett project where researchers at Fraunhofer HHI develop technical methods for exercise programs to benefit children with Rett syndrome, a very rare genetic disorder.
The EPSILON project
Objective and hybrid assessment of cognitive and fatigue-associated Post-COVID symptoms with multimodal tools
Duration:
September 2023–February 2026
Project funded by:
German Federal Ministry of Research, Technology and Space (BMFTR)
Project partners:
• Fraunhofer Institute for Telecommunications, Heinrich-Hertz-Institut, HHI, Interactive and Cognitive Systems group
• Department of Neurology of Charité – Universitätsmedizin Berlin, Cognitive Neurology working group
• Max Planck Institute for Human Cognitive and Brain Sciences, Mind-Body-Emotion group
• Faculty of Medicine of University of Leipzig Medical Center, Clinic for Cognitive Neurology
https://www.fraunhofer.de/en/press/research-news/2025/october-2025/interactive-v...
The VR tools developed in the EPSILON project can be used for testing cognitive effort and spatial m ...
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