tetano
Editor, Senior Moderator
Brain Behav Immun
. 2020 Jul 29;S0889-1591(20)31606-8.
doi: 10.1016/j.bbi.2020.07.037. Online ahead of print.
Anxiety and depression in COVID-19 survivors: role of inflammatory and clinical predictors
Mario Gennaro Mazza[SUP] 1 [/SUP], Rebecca De Lorenzo[SUP] 2 [/SUP], Caterina Conte[SUP] 2 [/SUP], Sara Poletti[SUP] 3 [/SUP], Benedetta Vai[SUP] 3 [/SUP], Irene Bollettini[SUP] 3 [/SUP], Elisa Maria Teresa Melloni[SUP] 3 [/SUP], Roberto Furlan[SUP] 4 [/SUP], Fabio Ciceri[SUP] 2 [/SUP], Patrizia Rovere-Querini[SUP] 2 [/SUP], Francesco Benedetti[SUP] 3 [/SUP]
Affiliations
Abstract
Infection-triggered perturbation of the immune system could induce psychopathology, and psychiatric sequelae were observed after previous coronavirus outbreaks. The spreading of the Severe Acute Respiratory Syndrome Coronavirus (COVID-19) pandemic could be associated with psychiatric implications. We investigated the psychopathological impact of COVID-19 in survivors, also considering the effect of clinical and inflammatory predictors. We screened for psychiatric symptoms 402 adults surviving COVID-19 (265male,meanage58), at one month follow-up after hospital treatment. A clinical interview and a battery of self-report questionnaires were used to investigate post-traumatic stress disorder (PTSD), depression, anxiety, insomnia, and obsessive-compulsive (OC) symptomatology. We collected sociodemographic information, clinical data, baseline inflammatory markers and follow-up oxygen saturation levels. A significant proportion of patients self-rated in the psychopathological range: 28% for PTSD, 31% for depression, 42% for anxiety, 20% for OC symptoms, and 40% for insomnia. Overall, 56% scored in the pathological range in at least one clinical dimension. Despite significantly lower levels of baseline inflammatory markers, females suffered more for both anxiety and depression. Patients with a positive previous psychiatric diagnosis showed increased scores on most psychopathological measures, with similar baseline inflammation. Baseline systemic immune-inflammation index (SII), which reflects the immune response and systemic inflammation based on peripheral lymphocyte, neutrophil and platelet counts, positively associated with scores of depression and anxiety at follow-up. PTSD, major depression, and anxiety, are all high-burden non-communicable conditions associated with years of life lived with disability. Considering the alarming impact of COVID-19 infection on mental health, the current insights on inflammation in psychiatry, and the present obervation of worse inflammation leading to worse depression, we recommend to assess psychopathology of COVID-19 survivors and to deepen research on inflammatory biomarkers, in order to diagnose and treat emergent psychiatric conditions.
Keywords: COVID-19; COVID-19 survivors; PTSD; anxiety; depression; inflammation; insomnia; mental health; obsessive-compulsive disorder; psychopathology.
. 2020 Jul 29;S0889-1591(20)31606-8.
doi: 10.1016/j.bbi.2020.07.037. Online ahead of print.
Anxiety and depression in COVID-19 survivors: role of inflammatory and clinical predictors
Mario Gennaro Mazza[SUP] 1 [/SUP], Rebecca De Lorenzo[SUP] 2 [/SUP], Caterina Conte[SUP] 2 [/SUP], Sara Poletti[SUP] 3 [/SUP], Benedetta Vai[SUP] 3 [/SUP], Irene Bollettini[SUP] 3 [/SUP], Elisa Maria Teresa Melloni[SUP] 3 [/SUP], Roberto Furlan[SUP] 4 [/SUP], Fabio Ciceri[SUP] 2 [/SUP], Patrizia Rovere-Querini[SUP] 2 [/SUP], Francesco Benedetti[SUP] 3 [/SUP]
Affiliations
- PMID: 32738287
- DOI: 10.1016/j.bbi.2020.07.037
Abstract
Infection-triggered perturbation of the immune system could induce psychopathology, and psychiatric sequelae were observed after previous coronavirus outbreaks. The spreading of the Severe Acute Respiratory Syndrome Coronavirus (COVID-19) pandemic could be associated with psychiatric implications. We investigated the psychopathological impact of COVID-19 in survivors, also considering the effect of clinical and inflammatory predictors. We screened for psychiatric symptoms 402 adults surviving COVID-19 (265male,meanage58), at one month follow-up after hospital treatment. A clinical interview and a battery of self-report questionnaires were used to investigate post-traumatic stress disorder (PTSD), depression, anxiety, insomnia, and obsessive-compulsive (OC) symptomatology. We collected sociodemographic information, clinical data, baseline inflammatory markers and follow-up oxygen saturation levels. A significant proportion of patients self-rated in the psychopathological range: 28% for PTSD, 31% for depression, 42% for anxiety, 20% for OC symptoms, and 40% for insomnia. Overall, 56% scored in the pathological range in at least one clinical dimension. Despite significantly lower levels of baseline inflammatory markers, females suffered more for both anxiety and depression. Patients with a positive previous psychiatric diagnosis showed increased scores on most psychopathological measures, with similar baseline inflammation. Baseline systemic immune-inflammation index (SII), which reflects the immune response and systemic inflammation based on peripheral lymphocyte, neutrophil and platelet counts, positively associated with scores of depression and anxiety at follow-up. PTSD, major depression, and anxiety, are all high-burden non-communicable conditions associated with years of life lived with disability. Considering the alarming impact of COVID-19 infection on mental health, the current insights on inflammation in psychiatry, and the present obervation of worse inflammation leading to worse depression, we recommend to assess psychopathology of COVID-19 survivors and to deepen research on inflammatory biomarkers, in order to diagnose and treat emergent psychiatric conditions.
Keywords: COVID-19; COVID-19 survivors; PTSD; anxiety; depression; inflammation; insomnia; mental health; obsessive-compulsive disorder; psychopathology.