TY - JOUR
T1 - Anxiety and depression in COVID-19 survivors
T2 - Role of inflammatory and clinical predictors
AU - COVID-19 BioB Outpatient Clinic Study group
AU - Mazza, Mario Gennaro
AU - De Lorenzo, Rebecca
AU - Conte, Caterina
AU - Poletti, Sara
AU - Vai, Benedetta
AU - Bollettini, Irene
AU - Melloni, Elisa Maria Teresa
AU - Furlan, Roberto
AU - Ciceri, Fabio
AU - Rovere-Querini, Patrizia
AU - Benedetti, Francesco
N1 - Funding Information:
The COVID-19 BioB Outpatient Clinic Study group also includes Nicola Farina, Valentina Sofia, Marta D'Amico, Paola Casanova, Giulia Magni, Marica Ferrante, Elisabetta Falbo, Elena Cinel, Elena Brioni, Cristiano Magnaghi, Chiara Lanzani, Valentina Canti, Alessandro Patrizi, Marta Cilla, Sabina Martinenghi, Giordano Vitali, Mona Rita Yacoub. None. None.
Publisher Copyright:
© 2020 Elsevier Inc.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/10
Y1 - 2020/10
N2 - 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 (265 male, mean age 58), 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 observation 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.
AB - 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 (265 male, mean age 58), 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 observation 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.
KW - Anxiety
KW - COVID-19
KW - COVID-19 survivors
KW - Depression
KW - Inflammation
KW - Insomnia
KW - Mental health
KW - Obsessive-compulsive disorder
KW - Psychopathology
KW - PTSD
UR - http://www.scopus.com/inward/record.url?scp=85089074187&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85089074187&partnerID=8YFLogxK
U2 - 10.1016/j.bbi.2020.07.037
DO - 10.1016/j.bbi.2020.07.037
M3 - Article
C2 - 32738287
AN - SCOPUS:85089074187
VL - 89
SP - 594
EP - 600
JO - Brain, Behavior, and Immunity
JF - Brain, Behavior, and Immunity
SN - 0889-1591
ER -