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Anxiety and depression in COVID-19 survivors: Role of inflammatory and clinical predictors.

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 (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.

SUBMITTER: Mazza MG

PROVIDER: S-EPMC7390748 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Anxiety and depression in COVID-19 survivors: Role of inflammatory and clinical predictors.

Mazza Mario Gennaro MG De Lorenzo Rebecca R Conte Caterina C Poletti Sara S Vai Benedetta B Bollettini Irene I Melloni Elisa Maria Teresa EMT Furlan Roberto R Ciceri Fabio F Rovere-Querini Patrizia P Benedetti Francesco F

Brain, behavior, and immunity 20200730

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 CO ...[more]

PMID: 32738287

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Project description:BackgroundThe coronavirus disease 2019 (COVID-19) pandemic directly affects the psychological well-being of critical care nurses. Several studies had investigated the psychological impact of the pandemic on nurses caring for patients with COVID-19, but few were conducted to identify the predictors of this impact.Aims and objectivesThe objective of this study is to identify the predictors of critical care nurses' stress, anxiety, and depression in response to the COVID-19 pandemic.DesignA cross-sectional survey was conducted in five intensive care units in five hospitals in Alexandria, Egypt.MethodsAn online questionnaire was distributed. It included socio-demographic and work-related data and the depression, anxiety, and stress scale scores of the nurses under study. A multiple linear regression model was developed to identify the predictors of critical care nurses' stress, anxiety, and depression in response to the COVID-19 pandemic.ResultsTwo hundred (64%) of 308 nurses completed the electronic questionnaire. Significant predictors of stress included the number of infected colleagues (P < .001) and availability of hospital resources (P = .01). Significant predictors of anxiety were age, gender, satisfactory income (P < .001), years of experience, time spent caring for patients with COVID-19 (P = .04), continuous training, number of infected colleagues (P = .01), and availability of hospital resources (P = .02). Finally, significant predictors of depression included gender, history of physical problems (P = .04), educational attainment, availability of hospital resources, history of psychological problems (P < .001), and number of infected colleagues (P = .001).ConclusionThe hospital's lack of human and physical resources and the number of colleagues infected with COVID-19 were the strongest predictors of stress, anxiety, and depression among nurses.Relevance to clinical practiceIdentifying the predictors of stress, anxiety, and depression among nurses who care for patients with COVID-19 is a vital step in developing mental health promotion strategies to support nurses during this pandemic.

Project description:Background: Studies have shown that working in frontline healthcare roles during epidemics and pandemics was associated with PTSD, depression, anxiety, and other mental health disorders. Objectives: The objectives of this study were to identify demographic, work-related and other predictors for clinically significant PTSD, depression, and anxiety during the COVID-19 pandemic in UK frontline health and social care workers (HSCWs), and to compare rates of distress across different groups of HCSWs working in different roles and settings. Methods: A convenience sample (n = 1194) of frontline UK HCSWs completed an online survey during the first wave of the pandemic (27 May - 23 July 2020). Participants worked in UK hospitals, nursing or care homes and other community settings. PTSD was assessed using the International Trauma Questionnaire (ITQ); Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9); Anxiety was assessed using the Generalized Anxiety Disorder Scale (GAD-7). Results: Nearly 58% of respondents met the threshold for a clinically significant disorder (PTSD = 22%; anxiety = 47%; depression = 47%), and symptom levels were high across occupational groups and settings. Logistic regression analyses found that participants who were concerned about infecting others, who could not talk with their managers if there were not coping, who reported feeling stigmatized and who had not had reliable access to personal protective equipment (PPE) were more likely to meet criteria for a clinically significant mental disorder. Being redeployed during the pandemic, and having had COVID were associated with higher odds for PTSD. Higher household income was associated with reduced odds for a mental disorder. Conclusions: This study identified predictors of clinically significant distress during COVID-19 and highlights the need for reliable access to PPE and further investigation of barriers to communication between managers and staff.

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Anxiety and depression in COVID-19 survivors: Role of inflammatory and clinical predictors.

Publications

Anxiety and depression in COVID-19 survivors: Role of inflammatory and clinical predictors.

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