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Liu Y, Li C, Ren H, Han K, Wang X, Zang S, Zhao G. The relationship of peripheral blood cell inflammatory biomarkers and psychological stress in unmedicated major depressive disorder. J Psychiatr Res 2024; 176:155-162. [PMID: 38865865 DOI: 10.1016/j.jpsychires.2024.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 05/07/2024] [Accepted: 06/08/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND Recent research has explored the linkage between major depressive disorder (MDD) and inflammation, especially via altered peripheral blood immune markers. However, the relationship between several novel leukocyte-derived ratios (LDR) and psychological stress in MDD remains uncertain. This study aimed to explore the relationship between LDR, clinical characteristics, recent life events, and childhood maltreatment in MDD patients. METHODS A cross-sectional case-control study was conducted involving 59 healthy controls (HC) and 50 unmedicated MDD patients. Subjects underwent psychological assessments and peripheral blood measurements. LDR assessed in this study included neutrophil-to-lymphocyte ratio (NLR), derived NLR (dNLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), white blood cell-to-mean platelet volume ratio (WMR), systemic immune inflammation index (SII), multiplication of neutrophil and monocyte counts (MNM), and systemic inflammation response index (SIRI). RESULTS MDD patients displayed significant alterations in WMR, PLR, and MNM compared to HC, as well as correlations between several LDR and various clinical features (duration of untreated psychosis and dNLR, the nine-item Patient Health Questionnaire and PLR, the 7-item Generalized Anxiety Disorder Questionnaire and SIRI (NLR and dNLR). There was a significant difference in the comparison of WMR in first-episode patients than in recurrent patients. Analyses further revealed an association between Life Event Scale total scores and NLR (dNLR). No correlation was found between Childhood Trauma Questionnaire total (or subscale) scores and LDR. Additionally, WMR and dNLR presented potential predictive value for distinguishing between MDD and HC. CONCLUSION The study concludes that MDD and some clinical features are associated with alterations in some peripheral blood LDR. These findings emphasize the potential role of peripheral blood LDR in the pathogenesis and clinical heterogeneity of MDD.
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Affiliation(s)
- Yigang Liu
- Department of Clinical Laboratory Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Cuicui Li
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Honghong Ren
- Department of Psychology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Ke Han
- Department of Rehabilitation, Shandong Provincial Hospital Affiliated to Shandong First Medical University Jinan, Shandong, China
| | - Ximing Wang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Shuqi Zang
- Department of Rehabilitation, Shandong Provincial Hospital Affiliated to Shandong First Medical University Jinan, Shandong, China
| | - Guoqing Zhao
- Department of Psychology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
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de Pádua Serafim A, Saffi F, Soares ARA, Morita AM, Assed MM, de Toledo S, Rocca CCA, Durães RSS. Cognitive performance of post-covid patients in mild, moderate, and severe clinical situations. BMC Psychol 2024; 12:236. [PMID: 38671529 PMCID: PMC11046800 DOI: 10.1186/s40359-024-01740-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 04/18/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Studying individuals with varying symptoms, from mild to severe, can provide valuable insights into the spectrum of cognitive outcomes after COVID-19. We investigated the cognitive performance of adults who recovered from the novel coronavirus disease (COVID-19) without prior cognitive complaints, considering mild (not hospitalized), moderate (ward), and severe (intensive care unit) symptoms. METHODS This cross-sectional study included 302 patients who recovered from COVID-19 (mild, n = 102; moderate, n = 102; severe, n = 98). We assessed intellectual quotient (IQ), attention, memory, processing speed, visual-constructive ability, as well as symptoms of depression, anxiety, and stress, at least eighteen months after infection. The mean length of hospitalization was Mdays=8.2 (SD = 3.9) and Mdays=14.4 (SD = 8.2) in the moderate and severe groups, respectively. RESULTS Cognitive difficulties were present in all three groups: mild (n = 12, 11.7%), moderate (n = 40, 39.2%), and severe (n = 48, 48.9%). Using Multinomial Logistic Regression and considering the odds ratio, our results indicated that a one-point increase in sustained attention, visual memory, and working memory might decrease the odds of being categorized in the severe group by 20%, 24%, and 77%, respectively, compared to the mild group. CONCLUSIONS Our findings provide empirical evidence regarding the long-term cognitive effects of COVID-19, particularly in individuals experiencing severe manifestations of the disease. We also highlighted the need for a comprehensive, multidimensional approach in rehabilitation programs to address the enduring cognitive impacts of COVID-19.
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Affiliation(s)
| | - Fabiana Saffi
- Institute of Psychiatry, University of São Paulo, São Paulo, Brazil
| | | | | | | | - Sandro de Toledo
- Institute of Psychology, University of Brasília, Brasília, Brazil
| | | | - Ricardo S S Durães
- Institute of Psychology, University of São Paulo, São Paulo, Brazil
- Institute of Psychology, University of Brasília, Brasília, Brazil
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Fann LY, Wen YL, Huang YC, Cheng CC, Huang YC, Fang CC, Chen WT, Yu PY, Pan HY, Kao LT. Depressive disorder and elevated risk of bell's palsy: a nationwide propensity score-weighting study. BMC Psychiatry 2024; 24:284. [PMID: 38627723 PMCID: PMC11020612 DOI: 10.1186/s12888-024-05730-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 03/28/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Prior studies have reported a potential relationship between depressive disorder (DD), immune function, and inflammatory response. Some studies have also confirmed the correlation between immune and inflammatory responses and Bell's palsy. Considering that the pathophysiology of these two diseases has several similarities, this study investigates if DD raises the risk of developing Bell's palsy. METHODS This nationwide propensity score-weighting cohort study utilized Taiwan National Health Insurance data. 44,198 patients with DD were identified as the DD cohort and 1,433,650 adult subjects without DD were identified as the comparison cohort. The inverse probability of treatment weighting (IPTW) strategy was used to balance the differences of covariates between two groups. The 5-year incidence of Bell's palsy was evaluated using the Cox proportional-hazard model, presenting results in terms of hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS The average age of DD patients was 48.3 ± 17.3 years, and 61.86% were female. After propensity score-weighting strategy, no significant demographic differences emerged between the DD and comparison cohort. The Cox proportional hazards model revealed a statistically significant adjusted IPTW-HR of 1.315 (95% CI: 1.168-1.481) for Bell's palsy in DD patients compared to comparison subjects. Further independent factors for Bell's palsy in this model were age (IPTW-HR: 1.012, 95% CI: 1.010-1.013, p < 0.0001), sex (IPTW-HR: 0.909, 95% CI: 0.869-0.952, p < 0.0001), hypertension (IPTW-HR: 1.268, 95% CI: 1.186-1.355, p < 0.0001), hyperlipidemia (IPTW-HR: 1.084, 95% CI: 1.001-1.173, p = 0.047), and diabetes (IPTW-HR: 1.513, 95% CI: 1.398-1.637, p < 0.0001) CONCLUSION: This Study confirmed that individuals with DD face an elevated risk of developing Bell's palsy. These findings hold significant implications for both clinicians and researchers, shedding light on the potential interplay between mental health and the risk of certain physical health outcomes.
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Affiliation(s)
- Li-Yun Fann
- Department of Nursing, Taipei City Hospital, Ren-Ai Branch, Taipei, Taiwan
- Department of Nurse-Midwifery and Women Health, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Yuan-Liang Wen
- School of Pharmacy, National Defense Medical Center, No.161, Sec. 6, Minquan E. Rd., Neihu Dist, 114201, Taipei City, Taiwan
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Yu-Chieh Huang
- Department of Psychiatry, Tri-Service General Hospital, Taipei, Taiwan
| | - Chih-Chien Cheng
- University of Taipei, Taipei, Taiwan
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
- Department of Obstetrics/Gynecology, Taipei City Hospital, Taipei, Taiwan
| | - Ying-Che Huang
- Department of Anesthesia and Critical Care Medicine, Taipei City Hospital, Ren-Ai Branch, Taipei, Taiwan
| | - Chih-Chia Fang
- Department of Nursing, Taipei City Hospital, Ren-Ai Branch, Taipei, Taiwan
| | - Wan-Ting Chen
- Department of Nursing, Taipei City Hospital, Ren-Ai Branch, Taipei, Taiwan
| | - Pei-Yeh Yu
- Department of Anesthesiology, Taipei City Hospital Ren Ai branch, Taipei, Taiwan
| | - Hsiang-Yi Pan
- Department of Pharmacy Practice, Tri-Service General Hospital, No.325, Sec.2, Chenggong Rd., Neihu District, 114202, Taipei City, Taiwan.
| | - Li-Ting Kao
- School of Pharmacy, National Defense Medical Center, No.161, Sec. 6, Minquan E. Rd., Neihu Dist, 114201, Taipei City, Taiwan.
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan.
- Department of Pharmacy Practice, Tri-Service General Hospital, No.325, Sec.2, Chenggong Rd., Neihu District, 114202, Taipei City, Taiwan.
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Ali NH, Al‐Kuraishy HM, Al‐Gareeb AI, Albuhadily AK, Hamad RS, Alexiou A, Papadakis M, Saad HM, Batiha GE. Role of brain renin-angiotensin system in depression: A new perspective. CNS Neurosci Ther 2024; 30:e14525. [PMID: 37953501 PMCID: PMC11017442 DOI: 10.1111/cns.14525] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/26/2023] [Accepted: 10/30/2023] [Indexed: 11/14/2023] Open
Abstract
Depression is a mood disorder characterized by abnormal thoughts. The pathophysiology of depression is related to the deficiency of serotonin (5HT), which is derived from tryptophan (Trp). Mitochondrial dysfunction, oxidative stress, and neuroinflammation are involved in the pathogenesis of depression. Notably, the renin-angiotensin system (RAS) is involved in the pathogenesis of depression, and different findings revealed that angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) may be effective in depression. However, the underlying mechanism for the role of dysregulated brain RAS-induced depression remains speculative. Therefore, this review aimed to revise the conceivable role of ACEIs and ARBs and how these agents ameliorate the pathophysiology of depression. Dysregulation of brain RAS triggers the development and progression of depression through the reduction of brain 5HT and expression of brain-derived neurotrophic factor (BDNF) and the induction of mitochondrial dysfunction, oxidative stress, and neuroinflammation. Therefore, inhibition of central classical RAS by ARBS and ACEIs and activation of non-classical RAS prevent the development of depression by regulating 5HT, BDNF, mitochondrial dysfunction, oxidative stress, and neuroinflammation.
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Affiliation(s)
- Naif H. Ali
- Department of Internal MedicineMedical CollegeNajran UniversityNajranKSA
| | - Hayder M. Al‐Kuraishy
- Department of Clinical Pharmacology and Medicine, College of MedicineMustansiriyah UniversityBaghdadIraq
| | - Ali I. Al‐Gareeb
- Department of Clinical Pharmacology and Medicine, College of MedicineMustansiriyah UniversityBaghdadIraq
| | - Ali K. Albuhadily
- Department of Clinical Pharmacology and Medicine, College of MedicineMustansiriyah UniversityBaghdadIraq
| | - Rabab S. Hamad
- Biological Sciences DepartmentCollege of Science, King Faisal UniversityAl AhsaSaudi Arabia
- Central LaboratoryTheodor Bilharz Research InstituteGizaEgypt
| | - Athanasios Alexiou
- University Centre for Research & Development, Chandigarh UniversityMohaliPunjabIndia
- Department of Science and EngineeringNovel Global Community Educational FoundationHebershamNew South WalesAustralia
- AFNP MedWienAustria
| | - Marios Papadakis
- Department of Surgery IIUniversity Hospital Witten‐Herdecke, University of Witten‐HerdeckeWuppertalGermany
| | - Hebatallah M. Saad
- Department of Pathology, Faculty of Veterinary MedicineMatrouh UniversityMatrouhEgypt
| | - Gaber El‐Saber Batiha
- Department of Pharmacology and Therapeutics, Faculty of Veterinary MedicineDamanhour UniversityDamanhourAlBeheiraEgypt
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Gonjilashvili A, Tatishvili S. The interplay between Sars-Cov-2 infection related cardiovascular diseases and depression. Common mechanisms, shared symptoms. AMERICAN HEART JOURNAL PLUS : CARDIOLOGY RESEARCH AND PRACTICE 2024; 38:100364. [PMID: 38510743 PMCID: PMC10945907 DOI: 10.1016/j.ahjo.2024.100364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 01/05/2024] [Accepted: 01/06/2024] [Indexed: 03/22/2024]
Abstract
In 2020 the World Health organization announced a pandemic due to the outbreak of the Coronavirus disease 19. Pneumonia was the most common manifestation of the Sars-Cov-2 infection, however, clinical papers describe Sars-Cov-2 associated cardiovascular pathologies, such as ACS, myopericarditis, cardiomyopathies, dysrhythmias, as leading causes of increased morbidity and mortality. The short and long term prognosis of Sars-Cov-2-related cardiovascular diseases was defined not only by the disease severity itself but also by associated conditions and complications, among which mental health issues (stress, depression and anxiety) have a negative impact. The interplay between Sars-Cov-2 infection, cardiovascular disease and depression may be explained by hyperinflammation, unhealthy lifestyle and inter-organ communication, mediated by extracellular vesicles (EV) and non-coding MicroRNA (miRNA). The long Covid syndrome is characterized with orthostatic hypotension, impaired cardiac and cerebral perfusion, postural orthostatic tachycardia syndrome (POTS), syncope, chest pain, dyspnea, palpitation, chronic fatigue syndrome, 'brain fog', memory, cognitive and sleep difficulties, depression and anxiety. From a clinical point of view these symptoms may be considered as common symptoms representing not only a cardiac but also a neurological/psychiatric problem. Consequently assessment of these symptoms are of paramount importance. Due to their complexity, management of these patients requires multidisciplinary care.
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del Corral T, Menor‐Rodríguez N, Fernández‐Vega S, Díaz‐Ramos C, Aguilar‐Zafra S, López‐de‐Uralde‐Villanueva I. Longitudinal study of changes observed in quality of life, psychological state cognition and pulmonary and functional capacity after COVID-19 infection: A six- to seven-month prospective cohort. J Clin Nurs 2024; 33:89-102. [PMID: 35534994 PMCID: PMC9348063 DOI: 10.1111/jocn.16352] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 01/06/2022] [Accepted: 04/22/2022] [Indexed: 12/24/2022]
Abstract
AIMS To investigate the health-related quality of life (HRQoL), symptoms, psychological and cognitive state and pulmonary and physical function of nonhospitalised COVID-19 patients at long-term, and to identify factors to predict a poor HRQoL in this follow-up. BACKGROUND Studies have focused on persistent symptoms of hospitalised COVID-19 patients in the medium term. Thus, long-term studies of nonhospitalised patients are urgently required. DESIGN A longitudinal cohort study. METHODS In 102 nonhospitalised COVID-19 patients, we collected symptoms at 3 months (baseline) and at 6-7 months (follow-up) from diagnosis (dyspnoea, fatigue/muscle weakness and chest/joint pain), HRQoL, psychological state, cognitive function, pulmonary and physical function. This study adhered to the STROBE statement. RESULTS HRQoL was impaired in almost 60% of the sample and remained impaired 6-7 months. At 3 months, more than 60% had impaired physical function (fatigue/muscle weakness and reduced leg and inspiratory muscle strength). About 40%-56% of the sample showed an altered psychological state (post-traumatic stress disorder (PTSD), anxiety/depression), cognitive function impairment and dyspnoea. At 6-7-months, only a slight improvement in dyspnoea and physical and cognitive function was observed, with a very high proportion of the sample (29%-55%) remained impaired. Impaired HRQoL at 6-7 months was predicted with 82.4% accuracy (86.7% sensitivity and 83.3% specificity) by the presence at 3 months of muscle fatigue/muscle weakness (OR = 5.7 (1.8-18.1)), PTSD (OR = 6.0 (1.7-20.7)) and impaired HRQoL (OR = 11.7 (3.7-36.8)). CONCLUSION A high proportion of nonhospitalised patients with COVID-19 experience an impaired HRQoL, cognitive and psychological function at long-term. HRQoL, PTSD and dyspnoea at 3 months can identify the majority of patients with COVID-19 who will have impaired quality of life at long-term. RELEVANCE TO CLINICAL PRACTICE Treatments aimed at improving psychological state and reducing the fatigue/muscle weakness of post-COVID-19 patients could be necessary to prevent the patients' HRQoL from being impaired at 6-7 months after their reported recovery.
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Affiliation(s)
- Tamara del Corral
- Department of Radiology, Rehabilitation and PhysiotherapyFaculty of Nursing, Physiotherapy and PodiatryUniversidad Complutense de Madrid (UCM)IdISSCMadridSpain
| | - Noemí Menor‐Rodríguez
- Departamento de FisioterapiaFacultad de Ciencias de la SaludCentro Superior de Estudios Universitarios La SalleUniversidad Autónoma de MadridMadridSpain
| | - Sara Fernández‐Vega
- Departamento de FisioterapiaFacultad de Ciencias de la SaludCentro Superior de Estudios Universitarios La SalleUniversidad Autónoma de MadridMadridSpain
| | - Celia Díaz‐Ramos
- Departamento de FisioterapiaFacultad de Ciencias de la SaludCentro Superior de Estudios Universitarios La SalleUniversidad Autónoma de MadridMadridSpain
| | - Sandra Aguilar‐Zafra
- Departamento de FisioterapiaFacultad de Ciencias de la SaludMotion in Brains Research GroupCentro Superior de Estudios Universitarios La SalleUniversidad Autónoma de MadridMadridSpain
- Téxum S.L Physiotherapy CenterCoslada, MadridSpain
| | - Ibai López‐de‐Uralde‐Villanueva
- Department of Radiology, Rehabilitation and PhysiotherapyFaculty of Nursing, Physiotherapy and PodiatryUniversidad Complutense de Madrid (UCM)IdISSCMadridSpain
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7
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Réus GZ, Recco KCC, Machado KMSH, Silva RH, Arent CO, Amboni G, Niero FS, Pedro LC, Borba LA, Bagatini MD, de Oliveira GG, da Silva AP, Mingoti MED, Ignácio ZM, Gava FF, Petronilho F, Quevedo J, Ceretta LB, de Azevedo Cardoso T. COVID-19, Anxiety, and Body Mass Index Increase Leptin Levels: a Cross-sectional Multicentric Study. Mol Neurobiol 2023:10.1007/s12035-023-03788-9. [PMID: 38123701 DOI: 10.1007/s12035-023-03788-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 11/08/2023] [Indexed: 12/23/2023]
Abstract
Although many efforts have been made to understand the pathophysiological mechanisms of COVID-19, critical gaps remain to be explored. This study aimed to investigate potential alterations in adipokine levels (specifically adiponectin, leptin, and resistin) among individuals with COVID-19. Within this population, we further assessed the association between these markers with both, body mass index (BMI) and psychiatric symptoms. This cross-sectional study included an age- and sex-matched sample of adults with COVID-19 (cases) and without COVID-19 (controls). We evaluated the severity of psychiatric symptoms, BMI, and adipokines. Individuals with COVID-19 presented greater BMI, stress levels, and leptin levels when compared to controls. Leptin levels were greater in individuals with moderate/severe COVID-19 as compared to individuals with COVID-19 who were asymptomatic or having mild symptoms. Leptin levels were positively correlated with BMI, severity of depressive and anxiety symptoms, and stress levels in the total sample. Leptin levels were also positively correlated with BMI, severity of anxiety symptoms, and stress levels in controls. In cases, there was a positive correlation between adiponectin and the severity of depressive symptoms and stress levels and leptin/resistin with BMI. A linear regression model revealed that BMI, severity of anxiety symptoms, and the diagnosis of COVID-19 are independently associated with increased leptin levels. Thus, leptin levels seem to be impacted by the COVID-19 infection, anxiety, and BMI.
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Affiliation(s)
- Gislaine Z Réus
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, 88806-000, Brazil.
| | - Kelen C C Recco
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, 88806-000, Brazil
| | - Karynne M S H Machado
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, 88806-000, Brazil
| | - Ritele H Silva
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, 88806-000, Brazil
| | - Camila O Arent
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, 88806-000, Brazil
| | - Graziela Amboni
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, 88806-000, Brazil
| | - Flávia S Niero
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, 88806-000, Brazil
| | - Lucas C Pedro
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, 88806-000, Brazil
| | - Laura A Borba
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, 88806-000, Brazil
| | - Margarete D Bagatini
- Laboratory of Physiology Pharmacology and Psychopathology, Graduate Program in Biomedical Sciences, Federal University of the Southern Frontier, Chapecó, SC, Brazil
| | - Gabriela G de Oliveira
- Laboratory of Physiology Pharmacology and Psychopathology, Graduate Program in Biomedical Sciences, Federal University of the Southern Frontier, Chapecó, SC, Brazil
| | - Alana Patrícia da Silva
- Laboratory of Physiology Pharmacology and Psychopathology, Graduate Program in Biomedical Sciences, Federal University of the Southern Frontier, Chapecó, SC, Brazil
| | - Maiqueli Eduarda D Mingoti
- Laboratory of Physiology Pharmacology and Psychopathology, Graduate Program in Biomedical Sciences, Federal University of the Southern Frontier, Chapecó, SC, Brazil
| | - Zuleide Maria Ignácio
- Laboratory of Physiology Pharmacology and Psychopathology, Graduate Program in Biomedical Sciences, Federal University of the Southern Frontier, Chapecó, SC, Brazil
| | - Fernanda F Gava
- Laboratory of Experimental Neurology, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina (UNESC), Criciúma, Santa Catarina, Brazil
| | - Fabricia Petronilho
- Laboratory of Experimental Neurology, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina (UNESC), Criciúma, Santa Catarina, Brazil
| | - João Quevedo
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, 88806-000, Brazil
- Center of Excellence on Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Luciane B Ceretta
- Graduate Program in Public Health, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
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Cheng AL, Anderson J, Didehbani N, Fine JS, Fleming TK, Karnik R, Longo M, Ng R, Re'em Y, Sampsel S, Shulman J, Silver JK, Twaite J, Verduzco-Gutierrez M, Kurylo M. Multi-disciplinary collaborative consensus guidance statement on the assessment and treatment of mental health symptoms in patients with post-acute sequelae of SARS-CoV-2 infection (PASC). PM R 2023; 15:1588-1604. [PMID: 37937672 DOI: 10.1002/pmrj.13085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 09/06/2023] [Accepted: 09/27/2023] [Indexed: 11/09/2023]
Affiliation(s)
- Abby L Cheng
- Division of Physical Medicine and Rehabilitation, Washington University, St. Louis, Missouri, USA
| | | | - Nyaz Didehbani
- Departments of Psychiatry and Physical Medicine & Rehabilitation at UT Southwestern Medical Center, Dallas, Texas, USA
| | - Jeffrey S Fine
- Department of Rehabilitation Medicine, Rusk Rehabilitation, NYU Langone Health, New York, New York, USA
| | - Talya K Fleming
- Department of Physical Medicine and Rehabilitation, JFK Johnson Rehabilitation Institute at Hackensack Meridian Health, Edison, New Jersey, USA
| | - Rasika Karnik
- Department of Medicine, University of Chicago, Chicago, Illinois, USA
| | - Michele Longo
- Department of Clinical Neurosciences, Tulane University, New Orleans, Louisiana, USA
| | - Rowena Ng
- Neuropsychology Department, Kennedy Krieger Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Yochai Re'em
- Department of Psychiatry, Weill Cornell Medicine, New York, New York, USA
| | - Sarah Sampsel
- SLSampsel Consulting, LLC, Albuquerque, New Mexico, USA
| | - Julieanne Shulman
- The Arthur S. Abramson Department of Physical Medicine and Rehabilitation, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Julie K Silver
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Massachusetts General Hospital, and Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Jamie Twaite
- The Arthur S. Abramson Department of Physical Medicine and Rehabilitation, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Monica Verduzco-Gutierrez
- Department of Rehabilitation Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Monica Kurylo
- Neurorehabilitation Psychology Services, University of Kansas Medical Center (KUMC) & Kansas University Health System, Kansas City, Kansas, USA
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Abdul-Ghani S, Lathan EC, Miao A, Gibbons R, Eghbalzad L, Powers A, Fani N. Contributions of Trauma and Economic Insecurity to Psychological Distress in Response to the COVID-19 Pandemic. MENTAL HEALTH SCIENCE 2023; 1:222-230. [PMID: 38707932 PMCID: PMC11068086 DOI: 10.1002/mhs2.36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 08/18/2023] [Indexed: 05/07/2024]
Abstract
Background Racially minoritized women with limited socioeconomic resources are at increased risk for adverse psychological outcomes in response to the COVID-19 pandemic. Disproportionate rates of trauma exposure and economic insecurity likely heighten risk for these outcomes among socioeconomically vulnerable individuals, but the unique contributions of these factors are poorly understood. As such, we examined trauma and economic factors as predictors of pandemic-related psychological distress and symptoms. Methods Ninety-six women recruited for a trauma research study (91.7% Black, Mage=38.3 years, SDage=11.8 years) completed measures of trauma exposure, economic insecurity, and several items assessing psychological distress and symptoms related to the COVID-19 pandemic. We examined concern for mental and physical health impacts of COVID-19 as well as changes in self-reported levels of anxiety and anhedonia from the three months prior to the pandemic to the past two weeks. Linear regression analyses were used to assess contributions of trauma exposure and economic insecurity to COVID-19-related distress. Results Childhood maltreatment and lifetime trauma exposure did not predict COVID-19-related distress; however, financial concern significantly contributed to concern for the physical health impact of COVID-19 (B = .30, p < .05). Food insecurity emerged as the only significant predictor of concern for mental health impact of COVID-19 (B=.91, p < .01). Housing instability was the only significant predictor of COVID-19-related increases in anhedonia (B = -.30, p < .05). Conclusions Economic insecurity, namely self-reported financial concern, food insecurity, and housing instability, was related to COVID-19-related psychological distress in a sample of predominately Black American women living in under-resourced communities. Findings may help identify populations at risk for COVID-19-related psychological distress and symptoms and develop effective interventions, such as expanding access to nutritious food sources and housing support, for minoritized community members.
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Affiliation(s)
- Sarah Abdul-Ghani
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Emma C Lathan
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Amanda Miao
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Rebecca Gibbons
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | | | - Abigail Powers
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Negar Fani
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
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10
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Seyedmirzaei H, Faramarzpour M, Saghazadeh A, Teixeira AL, Rezaei N. Post-COVID-19 depression and serum interleukin 6 levels: A systematic review and meta-analysis of COVID-19 convalescents with and without depression. World J Biol Psychiatry 2023; 24:811-821. [PMID: 37526618 DOI: 10.1080/15622975.2023.2242928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 07/27/2023] [Indexed: 08/02/2023]
Abstract
OBJECTIVES Depression is among the psychiatric sequelae of COVID-19, affecting more than 20% of the convalescents. Its underlying pathophysiology remains unclear. Interleukin 6 (IL-6), a pro-inflammatory cytokine, plays a critical role in the COVID-19-associated cytokine storm, has been implicated in depressive disorders, and may thus be involved in post-COVID-19 depression. METHODS PubMed, Scopus, Embase, and Web of Science were systematically searched for relevant studies assessing peripheral IL-6 levels in convalescents who developed depression after COVID-19 vs. convalescents who did not. RESULTS Five studies were included in our systematic review, and four entered the meta-analysis. The meta-analysis revealed that post-COVID people with de novo depression did not have statistically significant differences in IL-6 levels compared to those without depression (standardised mean difference (SMD) = 0.09, 95% confidence interval (CI) = -0.35, 0.54, p-value = 0.68). CONCLUSIONS Although convalescents with depression did not have significantly higher IL-6 levels than convalescents without depression, the results should be interpreted considering the limited sample size and the low power of the included studies.
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Affiliation(s)
- Homa Seyedmirzaei
- School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Mahsa Faramarzpour
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Amene Saghazadeh
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Systematic Review and Meta-Analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Antônio L Teixeira
- Neuropsychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Systematic Review and Meta-Analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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11
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Ansari S, Sanjari Moghaddam H, Basti FA, Salehi M, Akhondzadeh S. Efficacy and safety of celecoxib monotherapy for treatment of moderate depressive symptoms following COVID-19 infection: A randomized, double-blind, placebo-controlled trial. J Psychosom Res 2023; 174:111471. [PMID: 37660680 DOI: 10.1016/j.jpsychores.2023.111471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 08/16/2023] [Accepted: 08/18/2023] [Indexed: 09/05/2023]
Abstract
OBJECTIVE Celecoxib, a nonsteroidal anti-inflammatory agent, was found to be an effective add-on treatment for unipolar and bipolar depression. We investigated the potential beneficial effect of celecoxib monotherapy on depressive symptoms after Coronavirus disease (COVID-19). METHODS This was a randomized, double-blind, placebo-controlled clinical trial investigating the therapeutic effects of celecoxib monotherapy in patients with moderate depressive symptoms following COVID-19 infection. Patients were randomized to receive either a celecoxib capsule (100 mg) twice daily or a placebo capsule twice daily for 6 weeks. Participants were assessed with the Hamilton Depression Rating Scale (HDRS) and the side effect checklist at baseline and weeks 3 and 6. RESULTS A total of 62 patients were included. GLM repeated-measures showed a significant effect of time × treatment (F = 12.95, df = 1.98, p < 0.001) for celecoxib, suggesting superior improvement of depressive symptoms in celecoxib compared to placebo from baseline to the study endpoint. HDRS scores in the celecoxib group showed a greater decline from baseline to both week 3 (t = 4.12, p < 0.001, Cohen's d = 1.10) and week 6 (t = 4.76, p < 0.001, Cohen's d = 1.27), compared to the placebo group. Rate of response to treatment (70% vs 9%, p < 0.001) and remission (67% vs 0%, p < 0.001) was significantly higher in celecoxib compared to the placebo group at week 6. Adverse event frequencies were not significantly different between the two groups. CONCLUSION We demonstrated that treatment with celecoxib significantly improved depression scores of patients with depressive symptoms following COVID-19 infection. Further trials with larger sample sizes and longer study periods should assess our findings before any suggestion for clinical use. The trial was prospectively registered at the Iranian registry of clinical trials (www.irct.ir; registration number: IRCT20090117001556N142).
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Affiliation(s)
- Sahar Ansari
- Psychosomatic Medicine Research Center, Imam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Fatemeh A Basti
- Islamic Azad University, Tehran Medical Branch, Tehran, Iran
| | - Mohammadreza Salehi
- Research Center for Antibiotic Stewardship and Antimicrobial Resistance, Infectious Diseases Department, Imam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahin Akhondzadeh
- Psychiatric Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran.
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12
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Karkala A, Tzinas A, Kotoulas S, Zacharias A, Sourla E, Pataka A. Neuropsychiatric Outcomes and Sleep Dysfunction in COVID-19 Patients: Risk Factors and Mechanisms. Neuroimmunomodulation 2023; 30:237-249. [PMID: 37757765 DOI: 10.1159/000533722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 08/21/2023] [Indexed: 09/29/2023] Open
Abstract
The ongoing global health crisis due to the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has significantly impacted all aspects of life. While the majority of early research following the coronavirus disease caused by SARS-CoV-2 (COVID-19) has focused on the physiological effects of the virus, a substantial body of subsequent studies has shown that the psychological burden of the infection is also considerable. Patients, even without mental illness history, were at increased susceptibility to developing mental health and sleep disturbances during or after the COVID-19 infection. Viral neurotropism and inflammatory storm damaging the blood-brain barrier have been proposed as possible mechanisms for mental health manifestations, along with stressful psychological factors and indirect consequences such as thrombosis and hypoxia. The virus has been found to infect peripheral olfactory neurons and exploit axonal migration pathways, exhibiting metabolic changes in astrocytes that are detrimental to fueling neurons and building neurotransmitters. Patients with COVID-19 present dysregulated and overactive immune responses, resulting in impaired neuronal function and viability, adversely affecting sleep and emotion regulation. Additionally, several risk factors have been associated with the neuropsychiatric sequelae of the infection, such as female sex, age, preexisting neuropathologies, severity of initial disease and sociological status. This review aimed to provide an overview of mental health symptoms and sleep disturbances developed during COVID-19 and to analyze the underlying mechanisms and risk factors of psychological distress and sleep dysfunction.
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Affiliation(s)
- Aliki Karkala
- Respiratory Failure Unit, G. Papanikolaou Hospital, Thessaloniki and Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Asterios Tzinas
- Respiratory Failure Unit, G. Papanikolaou Hospital, Thessaloniki and Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Athanasios Zacharias
- Respiratory Failure Unit, G. Papanikolaou Hospital, Thessaloniki and Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Evdokia Sourla
- Respiratory Failure Unit, G. Papanikolaou Hospital, Thessaloniki and Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Athanasia Pataka
- Respiratory Failure Unit, G. Papanikolaou Hospital, Thessaloniki and Aristotle University of Thessaloniki, Thessaloniki, Greece
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13
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de Azevedo Cardoso T, Silva RH, Fernandes JL, Arent CO, Amboni G, Borba LA, Padilha APZ, Botelho MEM, Maciel AL, Barichello T, Morales R, Soares SJB, Bagatini MD, Dallagnol C, Brighenti ME, Ignácio ZM, Quevedo J, Ceretta LB, Réus GZ. Stress levels, psychological symptoms, and C-reactive protein levels in COVID-19: A cross-sectional study. J Affect Disord 2023; 330:216-226. [PMID: 36907459 PMCID: PMC10005840 DOI: 10.1016/j.jad.2023.03.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 02/28/2023] [Accepted: 03/07/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND Although many studies have pointed out a possible relationship between COVID-19 and the presence of psychiatric disorders, the majority of the studies have significant limitations. This study investigates the influence of COVID-19 infection on mental health. METHODS This cross-sectional study included an age- and sex-matched sample of adult individuals positive (cases) or negative (controls) for COVID-19. We evaluated the presence of psychiatric conditions and C-reactive protein (CRP). RESULTS Findings showed greater severity of depressive symptoms, higher levels of stress, and greater CRP in cases. The severity of depressive and insomnia symptoms, as well as the CRP were more remarkable in individuals with moderate/severe COVID-19. We found a positive correlation between stress and severity of anxiety, depression, and insomnia in individuals with or without COVID-19. There was a positive correlation between CRP levels and severity of depressive symptoms in cases and controls, and a positive correlation between CRP levels and the severity of anxiety symptoms and stress levels only in individuals with COVID-19. Individuals with COVID-19 and depression had greater CRP than those with COVID-19 without current major depressive disorder. LIMITATIONS We cannot infer causality because this is a cross-sectional study, and the majority of COVID-19 sample was asymptomatic or had mild symptoms, which may limit the generalizability of our findings for moderate/severe cases. CONCLUSIONS Individuals with COVID-19 showed greater severity of psychological symptoms, which may impact on the development of psychiatric disorders in the future. CPR seem to be a promising biomarker for earlier detection of post-COVID depression.
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Affiliation(s)
| | - Ritele H Silva
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Jessica L Fernandes
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Camila O Arent
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Graziela Amboni
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Laura A Borba
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Alex Paulo Z Padilha
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Maria Eduarda M Botelho
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Amanda L Maciel
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Tatiana Barichello
- Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil; Center of Excellence on Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Rodrigo Morales
- Department of Neurology, McGovern Medical School, UTHealth, Houston, TX, USA; Centro Integrativo de Biología y Química Aplicada (CIBQA), Universidad Bernardo O'Higgins, Santiago, Chile
| | - Silvio José B Soares
- Laboratory of Physiology Pharmacology and Psychopathology, Graduate Program in Biomedical Sciences, Federal University of the Southern Frontier, Chapecó, SC, Brazil
| | - Margarete D Bagatini
- Laboratory of Physiology Pharmacology and Psychopathology, Graduate Program in Biomedical Sciences, Federal University of the Southern Frontier, Chapecó, SC, Brazil
| | - Claudia Dallagnol
- Laboratory of Physiology Pharmacology and Psychopathology, Graduate Program in Biomedical Sciences, Federal University of the Southern Frontier, Chapecó, SC, Brazil
| | - Marta Elisa Brighenti
- Laboratory of Physiology Pharmacology and Psychopathology, Graduate Program in Biomedical Sciences, Federal University of the Southern Frontier, Chapecó, SC, Brazil
| | - Zuleide Maria Ignácio
- Laboratory of Physiology Pharmacology and Psychopathology, Graduate Program in Biomedical Sciences, Federal University of the Southern Frontier, Chapecó, SC, Brazil
| | - João Quevedo
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil; Center of Excellence on Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Luciane B Ceretta
- Graduate Program in Public Health, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Gislaine Z Réus
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil.
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14
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Jiang L, An X, Duan Y, Lian F, Jin D, Zhang Y, Yang C, Zhang Y, Kang X, Sun Y. The pathological mechanism of the COVID-19 convalescence and its treatment with traditional Chinese medicine. Front Pharmacol 2023; 13:1054312. [PMID: 36703736 PMCID: PMC9872123 DOI: 10.3389/fphar.2022.1054312] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 12/16/2022] [Indexed: 01/12/2023] Open
Abstract
The severe acute respiratory syndrome coronavirus - 2 (SARS - CoV - 2) was reported to cause the Wuhan outbreak of the corona virus disease 2019(COVID-19). To date, the COVID-19 has infected more than 600 million people gloabally. As a growing number of patients recover from acute infections and are discharged from hospitals, the proportion of patients in the recovery period is gradually increasing. Many of these individuals have been reported to experience multiple symptoms during the convalescence, such as fatigue, dyspnea and pain which are designated as "long-COVID", "post-COVID syndrome" or "recovery sequelae. We searched for recent articles published in PubMed on COVID-19 convalescence and found that the pathogenesis of COVID-19 convalescence is not yet well recognized. It may be associated with incomplete recovery of immune system, parenchymal organ damage (liver or lung), coagulation abnormalities, "second hit" caused by viral infection, and Phenomenon of Cell Senescence-Associated Secretory Phenotype (SASP). Some drugs and psychological factors of patients also play a non-negligible role in it. We also found that the effect of traditional Chinese medicine (TCM) is effective in the treatment of the COVID-19 recovery phase, which can not only relieve the corresponding symptoms, but also improve the indicators and pulmonary fibrosis. Bufei Huoxue Capsule, as the only drug explicitly mentioned for COVID-19 recovery period, can exert strong rehabilitative effects on physiological activity in patients recovering from COVID-19. In addition, in previous studies, traditional Chinese medicine has been confirmed to have the ability to resist cytokine storms, as well as improve coagulation and myocardial damage, which makes it have potential therapeutic advantages in targeting the hyperimmune response, coagulation abnormalities and myocardial damage existing in the recovery period. In conclusion, the clinical symptoms of patients convalescing from COVID-19 are complex, and its pathogenesis has not been elucidated. traditional Chinese medicine, as a traditional treatment, its specific action and mechanism need to be confirmed by more studies, so that it can play a better role.
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Affiliation(s)
- Linlin Jiang
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Beijing University of Chinese Medicine, Beijing, China
| | - Xuedong An
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yingying Duan
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Beijing University of Chinese Medicine, Beijing, China
| | - Fengmei Lian
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - De Jin
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yuehong Zhang
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Cunqing Yang
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yuqing Zhang
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiaomin Kang
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Beijing University of Chinese Medicine, Beijing, China
| | - Yuting Sun
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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15
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Orsolini L, Pompili S, Volpe U. C-Reactive Protein (CRP): A Potent Inflammation Biomarker in Psychiatric Disorders. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1411:135-160. [PMID: 36949309 DOI: 10.1007/978-981-19-7376-5_7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
An increasing number of studies have investigated the role of inflammation in psychiatric disorders, by demonstrating how an altered/dysfunctional immunological and inflammatory system may underpin a psychiatric condition. Particularly, several studies specifically investigated the role of a neuroinflammatory biomarker, named C-reactive protein (CRP), in psychiatric disorders. Overall, even though scientific literature so far published still does not appear definitive, CRP is more likely reported to be elevated in several psychiatric disorders, including schizophrenia, mood disorders, anxiety disorders and post-traumatic stress disorder. Moreover, a low-grade inflammation (CRP >3 mg/L) has been more likely observed in a subgroup of patients affected with a more severe psychopathological symptomatology, more treatment resistance and worst clinical mental illness course, strengthening the hypothesis of the need for a different clinical and prognostic characterization based on this concomitant neuroinflammatory predisposition. However, even though further research studies are needed to confirm this preliminary evidence, CRP may represent a potential clinical routine biomarker which could be integrated in the clinical routine practice to better characterize clinical picture and course as well as address clinicians towards a personalized treatment.
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Affiliation(s)
- Laura Orsolini
- Unit of Clinical Psychiatry, Department of Clinical Neurosciences/DIMSC, Polytechnic University of Marche, Ancona, Italy.
| | - Simone Pompili
- Unit of Clinical Psychiatry, Department of Clinical Neurosciences/DIMSC, Polytechnic University of Marche, Ancona, Italy
| | - Umberto Volpe
- Unit of Clinical Psychiatry, Department of Clinical Neurosciences/DIMSC, Polytechnic University of Marche, Ancona, Italy
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16
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Khushboo, Siddiqi NJ, Sharma B. Pathophysiology of SARS-CoV2 Mediated Depression, Therapeutics, and Consequences: A Comprehensive Narrative. Mini Rev Med Chem 2023; 23:217-229. [PMID: 35658879 DOI: 10.2174/1381612828666220603150637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/31/2022] [Accepted: 04/13/2022] [Indexed: 11/22/2022]
Abstract
The Coronavirus Disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Coronavirus type 2 (SARS-CoV-2), belongs to emerging and reemerging diseases, which was first identified and reported in Wuhan, China, in December 2019. The genetic sequence of SARS-CoV-2 was similar to the SARS virus, a β-coronavirus. The epidemiological studies suggest that the transmission of SARS-CoV-2 mainly occurs from an infected person to others through close contact with the respiratory droplets or by having contact with SARS-CoV-2 adhering to objects and surfaces. The incubation period ranges from 5 to14 days. The symptoms include fever, dry cough, tiredness, aches, chest pain, conjunctivitis, diarrhea, headache, difficulty in breathing or short breath, loss of taste, smell, rashes on the skin, and sore throat. Some reports indicated that males exhibited lower scores than females, the younger populations displayed increased symptoms, Chinese/Taiwanese people registered only scarce symptoms, and Canadians experienced more symptoms. The results of several studies suggested that while COVID-19 had a significant effect on depression, job instability affected anxiety and depression. The diagnostics to detect the presence of coronavirus involve ELISA and RT-PCR. There is no specific treatment available to eradicate COVID-19. The therapeutics used to treat COVID 19 exhibited severe side effects. Recently, some Indian traditional medicinal plants have shown promise in reducing the risk of viral infection and also boosting the immunity of an individual. This paper presents an overview of the current status of depression in the SARS CoV2 infected people and the measures required to overcome COVID-19 induced depression in patients even after recovery.
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Affiliation(s)
- Khushboo
- Departments of Biochemistry, University of Allahabad, Allahabad 211002, UP-India
| | - Nikhat J Siddiqi
- Department of Biochemistry, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
| | - Bechan Sharma
- Departments of Biochemistry, University of Allahabad, Allahabad 211002, UP-India
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17
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Wang M, Liu Z, Wang Z, Li K, Tian Y, Lu W, Hong J, Peng X, Shi J, Zhang Z, Mei G. Clinical characteristics of 1139 mild cases of the SARS-CoV-2 Omicron variant infected patients in Shanghai. J Med Virol 2023; 95:e28224. [PMID: 36238984 PMCID: PMC9874495 DOI: 10.1002/jmv.28224] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 09/21/2022] [Accepted: 10/11/2022] [Indexed: 01/27/2023]
Abstract
In March 2022, the Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) surged during the Coronavirus Disease 2019 (COVID-19) pandemic in Shanghai, but over 90% of patients were mild. This study included 1139 COVID-19 patients mildly infected with the Omicron variant of SARS-CoV-2 in Shanghai from May 1 to 10, 2022, aiming to clarify the demographic characteristics and clinical symptoms of patients with mild Omicron infection. The clinical phenotypes of Omicron infection were identified by model-based cluster analysis to explore the features of different clusters. The median age of the patients was 41.0 years [IQR: 31.0-52.0 years] and 73.0% were male. The top three clinical manifestations are cough (57.5%), expectoration (48.3%), and nasal congestion and runny nose (43.4%). The prevalence of nasal congestion and runny nose varied significantly across the doses of vaccinations, with 23.1% in the unvaccinated population and 30%, 45.9%, and 44.3% in the 1-dose, 2-dose and 3-dose vaccinated populations, respectively. In addition, there were significant differences for fever (23.1%, 26.0%, 28.6%, 18.4%), head and body heaviness (15.4%, 14.0%, 26.7%, 22.4%), and loss of appetite (25.6%, 30.0%, 33.6%, 27.7%). The unvaccinated population had a lower incidence of symptoms than the vaccinated population. Cluster analysis revealed that all four clusters had multisystemic symptoms and were dominated by both general and respiratory symptoms. The more severe the degree of the symptoms was, the higher the prevalence of multisystemic symptoms will be. The Omicron variant produced a lower incidence of symptoms in mildly infected patients than previous SARS-CoV-2 variants, but the clinical symptoms caused by the Omicron variant are more complex, so that it needs to be differentiated from influenza.
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Affiliation(s)
- Miao Wang
- Department of Internal Medicine of Traditional Chinese Medicine, Longhua HospitalShanghai University of Traditional Chinese MedicineShanghaiChina
| | - Zhidong Liu
- Department of Internal Medicine of Traditional Chinese Medicine, Longhua HospitalShanghai University of Traditional Chinese MedicineShanghaiChina
| | - Zengliang Wang
- Department of Epidemiology, School of Public Health, Cheeloo College of MedicineShandong UniversityJinanChina
| | - Ke Li
- Department of Epidemiology and Health Statistics, School of Public HealthFudan UniversityShanghaiChina
| | - Yu Tian
- Department of Internal Medicine of Traditional Chinese Medicine, Longhua HospitalShanghai University of Traditional Chinese MedicineShanghaiChina
| | - Wei Lu
- Department of Nursing, Longhua HospitalShanghai University of Traditional Chinese MedicineShanghaiChina
| | - Jie Hong
- Department of Epidemiology and Health Statistics, School of Public HealthFudan UniversityShanghaiChina
| | - Xinwei Peng
- Department of Epidemiology and Health Statistics, School of Public HealthFudan UniversityShanghaiChina
| | - Jin Shi
- Department of Epidemiology and Health Statistics, School of Public HealthFudan UniversityShanghaiChina
| | - Zhijie Zhang
- Department of Epidemiology and Health Statistics, School of Public HealthFudan UniversityShanghaiChina
| | - Guojiang Mei
- Department of Internal Medicine of Traditional Chinese Medicine, Longhua HospitalShanghai University of Traditional Chinese MedicineShanghaiChina
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18
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Exploration of Correlations between COVID-19 Vaccination Choice and Public Mental Health Using Google Trend Search. Vaccines (Basel) 2022; 10:vaccines10122173. [PMID: 36560583 PMCID: PMC9781700 DOI: 10.3390/vaccines10122173] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/08/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022] Open
Abstract
Since the global COVID-19 pandemic has great impact on human health and life style, the vaccination is the most effective method for disease control and prevention. However, not all people are willing to be vaccinated because some critical factors affect vaccination aspiration and vaccine choice of the public population. Among these factors, public mental health belongs to a political issue. In this study, Google Trend Search was used to explore the correlation between COVID-19 vaccination choice and public mental health during the period from August/2020 to December/2021. The results suggested that the main public concerns of COVID-19-related mental illnesses are positively correlated with the new cases amount but are negatively correlated with total cases and vaccinated cases amount. Moreover, the results support that the public population took more interest in the Pfizer/BNT COVID vaccine and Moderna COVID vaccine than the AstraZeneca COVID vaccine. Our study shows that investigations of the public mental health should be set up and conducted widely. A complete vaccination program combined with a policy for the improvement of public mental health are very effective for the control and prevention of COVID-19.
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Xie W, Wang C, Lin Z, Luo X, Chen W, Xu M, Liang L, Liu X, Wang Y, Luo H, Cheng M. Multimodal fusion diagnosis of depression and anxiety based on CNN-LSTM model. Comput Med Imaging Graph 2022; 102:102128. [PMID: 36272311 DOI: 10.1016/j.compmedimag.2022.102128] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 09/20/2022] [Accepted: 09/28/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND In recent years, more and more people suffer from depression and anxiety. These symptoms are hard to be spotted and can be very dangerous. Currently, the Self-Reported Anxiety Scale (SAS) and Self-Reported Depression Scale (SDS) are commonly used for initial screening for depression and anxiety disorders. However, the information contained in these two scales is limited, while the symptoms of subjects are various and complex, which results in the inconsistency between the questionnaire evaluation results and the clinician's diagnosis results. To fully mine the scale data, we propose a method to extract the features from the facial expression and movements, which are generated from the video recorded simultaneously when subjects fill in the scale. Then we collect the facial expression, movements and scale information to establish a multimodal framework for improving the accuracy and robustness of the diagnosis of depression and anxiety. METHODS We collect the scale results of the subjects and the videos when filling in the scales. Given the two scales, SAS and SDS, we construct a model with two branches, where each branch processes the multimodal data of SAS and SDS, respectively. In the branch, we first build a convolutional neural network (CNN) to extracts the facial expression features in each frame of images. Secondly, we establish a long short-term memory (LSTM) network to further embedding the facial expression feature and build the connections between various frames, so that the movement feature in the video can be generated. Thirdly, we transform the scale scores into one-hot format, and feed them into the corresponding branch of the network to further mining the information of the multimodal data. Finally, we fuse the embeddings of these two branches to generate inference results of depression and anxiety. RESULTS AND CONCLUSIONS Based on the score results of SAS and SDS, our multimodal model further mines the video information, and can reach the accuracy of 0.946 in diagnosing depression and anxiety. This study demonstrates the feasibility of using our CNN-LSTM-based multimodal model for initial screening and diagnosis of depression and anxiety disorders with high diagnostic performance.
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Affiliation(s)
- Wanqing Xie
- Department of Intelligent Medical Engineering, School of Biomedical Engineering, Anhui Medical University, Hefei, China; Department of Psychology, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China; Suzhou Fanhan Information Technology Company, Ltd, Suzhou, China
| | - Chen Wang
- College of the Mathematical Sciences, Harbin Engineering University, Harbin, China
| | - Zhixiong Lin
- Department of Psychiatry, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Xudong Luo
- Department of Psychiatry, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Wenqian Chen
- College of the Mathematical Sciences, Harbin Engineering University, Harbin, China
| | - Manzhu Xu
- Department of Biological Sciences, Rensselaer Polytechnic Institute, Troy, NY 12180, USA
| | - Lizhong Liang
- Department of Psychiatry, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China; School of Computer Science and Engineering, Sun Yat-sen University, Guangzhou, China
| | - Xiaofeng Liu
- Suzhou Fanhan Information Technology Company, Ltd, Suzhou, China; Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA
| | - Yanzhong Wang
- School of Population Health & Environmental Sciences, Faculty of Life Science and Medicine, King's College London, London, UK
| | - Hui Luo
- Marine Biomedical Research Institute of Guangdong Medical University, Zhanjiang 510240, China.
| | - Mingmei Cheng
- Department of Intelligent Medical Engineering, School of Biomedical Engineering, Anhui Medical University, Hefei, China; Department of Psychology, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China.
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Hazumi M, Usuda K, Okazaki E, Kataoka M, Nishi D. Differences in the Course of Depression and Anxiety after COVID-19 Infection between Recovered Patients with and without a Psychiatric History: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811316. [PMID: 36141588 PMCID: PMC9517442 DOI: 10.3390/ijerph191811316] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/05/2022] [Accepted: 09/06/2022] [Indexed: 05/03/2023]
Abstract
BACKGROUND This study aimed to examine the course of depression and anxiety in COVID-19 survivors with a psychiatric history compared with those without a psychiatric history. METHODS A web-based cross-sectional survey for COVID-19 survivors was conducted from July to September 2021. A total of 6016 COVID-19 survivors, the accuracy of whose responses was determined to be assured, were included in analyses. Exposures included psychiatric history and time since COVID-19 infection, and the main outcomes and measures included severity of depression and anxiety, as assessed using the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7), respectively. RESULTS Mean severity of PHQ-9 and GAD-7 were significantly higher in participants with a psychiatric history than in those without a psychiatric history. Two-way analysis of covariance for PHQ-9 showed a significant main effect of the presence of psychiatric history and a significant interaction effect of psychiatric history × time since infection. Two-way analysis of covariance for the GAD-7 score revealed a significant main effect of the presence of psychiatric history and time since COVID-19 infection and the interaction effect of these factors. CONCLUSIONS The course of depression and anxiety was more severe in COVID-19 survivors with a psychiatric history than in those without a psychiatric history.
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Affiliation(s)
- Megumi Hazumi
- Department of Public Mental Health Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan
- Department of Sleep-Wake Disorder, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan
| | - Kentaro Usuda
- Department of Public Mental Health Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan
| | - Emi Okazaki
- Department of Public Mental Health Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan
| | - Mayumi Kataoka
- Department of Public Mental Health Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8654, Japan
| | - Daisuke Nishi
- Department of Public Mental Health Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8654, Japan
- Correspondence:
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Zajenkowska A, Wiśniewska D, Leniarska M, Jasielska MD, Bodecka M, Zajenkowski MM, Kaźmierczak I, Klimiuk J, Niemczyk L, Niemczyk K, Pinkham AE. Predictors of depressive symptoms among hospitalized COVID-19 patients with respiratory problems. PSYCHOL HEALTH MED 2022; 28:1288-1297. [PMID: 36082408 DOI: 10.1080/13548506.2022.2121970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
COVID-19 patients and survivors quite often experience depressive symptoms, which can increase risk for lower immune system response and poorer recovery. Vulnerability to depressive symptoms may be elevated in those patients who have the most severe COVID-19 course of illness, that is, patients who require supplementary oxygen therapy or even intubation. The current study involved a unique sample of patients who were hospitalized due to COVID-19 and who required respiratory support (N = 34, 10 women) in which we investigated depressive symptoms as well as psychopathological personality traits (PID5) as predictors. The majority of patients (76.5%) presented some degree of depressive symptoms. Although we expected severe levels of depressive symptoms to be most prevalent, more patients showed rather moderate levels. At the same time, Negative Affectivity was most predictive of depressive symptoms. We suggest that medical care for patients with greater emotional sensitivity and vulnerability to stress be supplemented with psychological support in order to address depressive symptoms and foster recovery.
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Affiliation(s)
- Anna Zajenkowska
- Maria Grzegorzewska University, Institute of Psychology, Warsaw, Poland
| | | | | | | | - Marta Bodecka
- Maria Grzegorzewska University, Institute of Psychology, Warsaw, Poland
| | | | | | - Joanna Klimiuk
- Department of Internal Diseases, Pneumonology and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - Longin Niemczyk
- Department of Nephrology, Dialysis and Internal Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Kazimierz Niemczyk
- Department of Otorhinolaryngology Head and Neck Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Amy E Pinkham
- School of Behavioral and Brain Sciences, the University of Texas at Dallas, Richardson, Texas, USA.,Department of Psychiatry, University of Texas Southwestern Medical School, Dallas, Texas, USA
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22
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Mallet J, Massini C, Dubreucq J, Padovani R, Fond G, Guessoum SB. Santé mentale et Covid : toutes et tous concernés. Une revue narrative. ANNALES MÉDICO-PSYCHOLOGIQUES, REVUE PSYCHIATRIQUE 2022; 180:707-712. [PMID: 35959286 PMCID: PMC9356619 DOI: 10.1016/j.amp.2022.07.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
La pandémie de COVID-19 (due au coronavirus SARS-CoV-2) a apporté des défis sans précédent en termes de santé publique, système de soins et vie quotidienne (incluant le travail et l’éducation), particulièrement lors de la première vague pandémique au début de l’année 2020. Afin de limiter la propagation du virus, de nombreux pays ont imposé des mesures restrictives pour favoriser la distanciation sociale, allant des couvre-feux et fermetures d’écoles à un confinement généralisé. Début 2022, on recense 135 000 décès dus au virus SARS-CoV-2 en France et près de 6 millions dans le monde. Au-delà de l’impact possible du SARS-CoV-2 sur le cerveau, la pandémie a été à l’origine de difficultés humaines complexes, avec un retentissement possible sur la santé mentale des populations. Dans cette revue narrative, nous résumons les données actuelles concernant l’impact de la pandémie sur la santé mentale en s’intéressant aux troubles psychiatriques en population générale et parmi les groupes vulnérables. L’objectif est de promouvoir une prévention ciblée sur ces populations. Notre revue a identifié plusieurs sous-groupes de sujets plus à risque de troubles psychiques dans le contexte de la pandémie de COVID-19 : les endeuillés par la COVID-19, les adolescents, les étudiants, les personnes atteintes par le virus (avec une atteinte potentiellement directe sur le cerveau) et enfin, le personnel de santé. Les disparités de genre ont également été accentuées, en défaveur des femmes. Des mesures de dépistage et de prévention doivent être prises pour limiter l’impact de cette pandémie sur la santé mentale. D’une façon plus générale, l’approche « une santé/one health » qui place la santé humaine (et donc mentale) à l’interface de la santé environnementale et animale semble indispensable pour éviter la survenue de ce type de pandémie et ses conséquences à l’avenir.
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Li T, Zhang L, Cai S, Lu Z, Bao W, Guo Z, Rong S. Association of mental health with clinical outcomes in hospitalized patients with moderate COVID-19. J Affect Disord 2022; 312:331-336. [PMID: 35577158 PMCID: PMC9098941 DOI: 10.1016/j.jad.2022.05.047] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 04/24/2022] [Accepted: 05/08/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To assess the association of depression and anxiety with clinical outcomes and laboratory markers among hospitalized patients with coronavirus disease 2019 (COVID-19). METHODS A prospective cohort study in Wuhan, China was conducted in 205 adult hospitalized patients with a diagnosis of moderate coronavirus disease from admission through discharge or death. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS). The primary outcome was the incidence of severe or critical COVID-19, and the secondary outcomes were increased length of hospital stay and altered laboratory markers during follow up. RESULTS Among the 205 hospitalized patients (mean age 58 years; 51.7% male), 25 (12.2%) developed severe or critical COVID-19. According to the HADS scores, 51 (24.9%) and 92 (44.9%) of participants presented with clinically significant anxiety and depression, respectively. Using multi-variable adjusted Cox regression analysis, the adjusted hazard ratio of developing severe or critical COVID-19 associated with anxiety and depression was 1.55 (95% CI: 0.63, 3.80) and 4.28 (95% CI: 1.20, 15.30), respectively. The risk of developing severe or critical COVID-19 with both anxiety and depression was more than four times higher than in patients without anxiety or depression (HR, 4.05; 95% CI: 1.02, 16.00). In addition, both the trends of depression and anxiety were positively associated with a prolonged duration of hospitalization, and immune response was significantly decreased in patients with depression than those without. CONCLUSIONS In patients having coronavirus disease, depression was associated with worse clinical outcomes. These findings highlight the importance of prevention and management of mental health problems in confronting the COVID-19 pandemic.
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Affiliation(s)
- Tingting Li
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Li Zhang
- Department of Neurology, Hubei Provincial Hospital of Integrated Chinese & Western Medicine, Wuhan 430015, China
| | - Sijie Cai
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Zijian Lu
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Wei Bao
- Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China
| | - Zhenli Guo
- Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China.
| | - Shuang Rong
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan 430065, China.
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Robust antiviral activity of commonly prescribed antidepressants against emerging coronaviruses: in vitro and in silico drug repurposing studies. Sci Rep 2022; 12:12920. [PMID: 35902647 PMCID: PMC9331004 DOI: 10.1038/s41598-022-17082-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 07/20/2022] [Indexed: 12/11/2022] Open
Abstract
During the current coronavirus disease 2019 (COVID-19) pandemic, symptoms of depression are commonly documented among both symptomatic and asymptomatic quarantined COVID-19 patients. Despite that many of the FDA-approved drugs have been showed anti-SARS-CoV-2 activity in vitro and remarkable efficacy against COVID-19 in clinical trials, no pharmaceutical products have yet been declared to be fully effective for treating COVID-19. Antidepressants comprise five major drug classes for the treatment of depression, neuralgia, migraine prophylaxis, and eating disorders which are frequently reported symptoms in COVID-19 patients. Herein, the efficacy of eight frequently prescribed FDA-approved antidepressants on the inhibition of both SARS-CoV-2 and MERS-CoV was assessed. Additionally, the in vitro anti-SARS-CoV-2 and anti-MERS-CoV activities were evaluated. Furthermore, molecular docking studies have been performed for these drugs against the spike (S) and main protease (Mpro) pockets of both SARS-CoV-2 and MERS-CoV. Results showed that Amitriptyline, Imipramine, Paroxetine, and Sertraline had potential anti-viral activities. Our findings suggested that the aforementioned drugs deserve more in vitro and in vivo studies targeting COVID-19 especially for those patients suffering from depression.
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25
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Tarantino S, Graziano S, Carducci C, Giampaolo R, Grimaldi Capitello T. Cognitive Difficulties, Psychological Symptoms, and Long Lasting Somatic Complaints in Adolescents with Previous SARS-CoV-2 Infection: A Telehealth Cross-Sectional Pilot Study. Brain Sci 2022; 12:brainsci12080969. [PMID: 35892410 PMCID: PMC9332506 DOI: 10.3390/brainsci12080969] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/05/2022] [Accepted: 07/21/2022] [Indexed: 02/05/2023] Open
Abstract
Background. Few studies have evaluated cognitive functioning and mental health in children and adolescents who contracted the SARS-CoV-2 infection. We investigated the prevalence and association of neuropsychological difficulties, psychological symptoms, and self-reported long-COVID complaints in a sample of adolescents. Methods. Thirty-one adolescents infected by COVID-19 within 3–6 months prior to the assessment were included. Neuropsychological difficulties, psychological symptoms, and self-reported long-COVID complaints were evaluated using a checklist and a battery of multiple standardized measures, using a telehealth procedure. Symptoms during the infection were also detected. Results. We included 31 adolescents (23 girls, 8 boys; mean age 14.1, SD = 2). We found borderline scores in 32.3% and 45.2% of our sample for phonemic and category fluency, respectively. A high percentage of participants showed symptoms of depression (80.6%) and anxiety (61.3%). Fifty-eight percent reported at least one long-COVID symptom. The most common symptoms were headache and attention problems (58%). Subjects presenting numbness/weakness, fatigue, brain fog, or attention problems had higher scores in depression, anxiety, and post-traumatic stress symptoms (p ≤ 0.05). Conclusion. This is a pilot study limited by the lack of control group. However, we found that cognitive, psychological, and physical symptoms were very common among adolescents recovered from COVID-19.
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Affiliation(s)
- Samuela Tarantino
- Department of Neurological Sciences, Unit of Clinical Psychology, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (S.G.); (C.C.); (T.G.C.)
- Correspondence: ; Tel.: +39-0668592228
| | - Sonia Graziano
- Department of Neurological Sciences, Unit of Clinical Psychology, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (S.G.); (C.C.); (T.G.C.)
| | - Chiara Carducci
- Department of Neurological Sciences, Unit of Clinical Psychology, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (S.G.); (C.C.); (T.G.C.)
| | - Rosaria Giampaolo
- Department of Paediatric Medicine, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy;
| | - Teresa Grimaldi Capitello
- Department of Neurological Sciences, Unit of Clinical Psychology, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (S.G.); (C.C.); (T.G.C.)
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Yang CP, Chang CM, Yang CC, Pariante CM, Su KP. Long COVID and long chain fatty acids (LCFAs): Psychoneuroimmunity implication of omega-3 LCFAs in delayed consequences of COVID-19. Brain Behav Immun 2022; 103:19-27. [PMID: 35390469 PMCID: PMC8977215 DOI: 10.1016/j.bbi.2022.04.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/21/2022] [Accepted: 04/01/2022] [Indexed: 12/12/2022] Open
Abstract
The global spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to the lasting pandemic of coronavirus disease 2019 (COVID-19) and the post-acute phase sequelae of heterogeneous negative impacts in multiple systems known as the "long COVID." The mechanisms of neuropsychiatric complications of long COVID are multifactorial, including long-term tissue damages from direct CNS viral involvement, unresolved systemic inflammation and oxidative stress, maladaptation of the renin-angiotensin-aldosterone system and coagulation system, dysregulated immunity, the dysfunction of neurotransmitters and hypothalamus-pituitaryadrenal (HPA) axis, and the psychosocial stress imposed by societal changes in response to this pandemic. The strength of safety, well-acceptance, and accumulating scientific evidence has now afforded nutritional medicine a place in the mainstream of neuropsychiatric intervention and prophylaxis. Long chain omega-3 polyunsaturated fatty acids (omega-3 or n-3 PUFAs) might have favorable effects on immunity, inflammation, oxidative stress and psychoneuroimmunity at different stages of SARS-CoV-2 infection. Omega-3 PUFAs, particularly EPA, have shown effects in treating mood and neurocognitive disorders by reducing pro-inflammatory cytokines, altering the HPA axis, and modulating neurotransmission via lipid rafts. In addition, omega-3 PUFAs and their metabolites, including specialized pro-resolvin mediators, accelerate the process of cleansing chronic inflammation and restoring tissue homeostasis, and therefore offer a promising strategy for Long COVID. In this article, we explore in a systematic review the putative molecular mechanisms by which omega-3 PUFAs and their metabolites counteract the negative effects of long COVID on the brain, behavior, and immunity.
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Affiliation(s)
- Chun-Pai Yang
- Department of Neurology, Kuang Tien General Hospital, Taichung, Taiwan; Department of Nutrition, HungKuang University, Taichung, Taiwan
| | - Ching-Mao Chang
- Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Institute of Traditional Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Cheng-Chia Yang
- Department of Healthcare Administration, Asia University, Taichung, Taiwan
| | | | - Kuan-Pin Su
- King's College London, London, UK; Mind-Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung, Taiwan; College of Medicine, China Medical University, Taichung, Taiwan; An-Nan Hospital, China Medical University, Tainan, Taiwan.
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Mood-congruent negative thinking styles and cognitive vulnerability in depressed COVID-19 survivors: A comparison with major depressive disorder. J Affect Disord 2022; 308:554-561. [PMID: 35460737 PMCID: PMC9020513 DOI: 10.1016/j.jad.2022.04.077] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 04/08/2022] [Accepted: 04/13/2022] [Indexed: 10/28/2022]
Abstract
BACKGROUND COVID-19 is associated with depressive psychopathology in survivors. Negative thinking styles are a core feature of major depression, fostering the experience of negative emotions and affects and hampering recovery. This cognitive vulnerability has been observed in medical conditions associated with depression, but never explored in post-COVID depression. METHODS We studied 729 participants: 362 COVID-19 survivors, 73 inpatients with Major Depressive Disorder (MDD), and 294 healthy participants (HC). Severity of depression was self-rated on the Zung Self-Rating Depression Scale (ZSDS). Neuropsychological bias toward negative emotional stimuli and the negative outlook on the self were tested in a self-description task, yielding latencies and frequencies of attribution of morally tuned elements. Dimensions of negative thinking and depressive cognitive style in evaluation of hypothetical events were measured on the Cognition Questionnaire (CQ). RESULTS 22.4% COVID survivors self-rated depression above the clinical threshold. Frequencies and latencies of attribution of morally negative elements, and CQ scores, correlated between themselves and predicted ZSDS scores, with post-COVID depressed patients showing intermediate scores between the more severe MDD patients, and non-depressed post-COVID participants and HC. LIMITATIONS Recruitment was in a single center, thus raising the possibility of population stratification. CONCLUSIONS The breadth of self-reproach and depressive cognitive style in evaluating events showed the same association with severity of depression in MDD and in post-COVID depressed patients, distributing along a gradient of severity, thus suggesting that individual features of negative thinking styles are shared in these conditions, and should be addressed as treatment targets in depressed COVID-19 survivors.
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Xiao H, Liu Q, Mei H, Xue Q, Cai X, Xie X, Xia Z, Zhou Y, Li H, Zhu K, Wan Z, Song R, Liu Z. Behavioral problems of pediatric patients recovered from COVID-19 in Wuhan, China. Acta Psychol (Amst) 2022; 226:103571. [PMID: 35366515 PMCID: PMC8934713 DOI: 10.1016/j.actpsy.2022.103571] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 03/03/2022] [Accepted: 03/16/2022] [Indexed: 12/13/2022] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) is profoundly affecting lives around the globe. Previous studies on COVID-19 mainly focused on epidemiological, clinical, and radiological features of patients with confirmed infection. Little attention has been paid to the follow-up of recovered patients. As a vulnerable population to adverse events, the health status of the COVID-19 recovered pediatric patients is of great concern. We aimed to investigate the prevalence of behavioral problems among pediatric patients recovered from the COVID-19 in Wuhan, China. Methods A total of 122 children who were suspected or confirmed COVID-19 cases and hospitalized for treatment were enrolled in the study between April 2020 and May 2020 in Wuhan, China. We collected related information about hospitalization and discharge of the children and emotional symptoms of their parents through electronic medical records and questionnaire. The behavioral problems of children were examined by applying the parent-reported the Strengths and Difficulties Questionnaire (SDQ). Results The participant children were discharged from hospital after about two months. Among them, 76 (62%) were boys, and the mean age was 6.71 years old. The highest prevalence of behavioral problems among pediatric children with COVID-19 was for prosocial behavior (15%), followed by total difficulties (13%), emotional symptoms (11%), hyperactivity (10%), conduct problems (9%), and peer problems (1%). With regarding to their parents, 26% reported having symptoms of anxiety and 23% as having symptoms of depression. The scores of SDQ were higher in those children whose parents have emotional problems compared to parents without. Conclusion Long-term follow up studies on the psychological and behavioral problems of COVID-19 recovered children and their parents are warranted.
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Dehghani A, Zokaei E, Kahani SM, Alavinejad E, Dehghani M, Meftahi GH, Afarinesh MR. The potential impact of Covid-19 on CNS and psychiatric sequels. Asian J Psychiatr 2022; 72:103097. [PMID: 35405524 PMCID: PMC8982477 DOI: 10.1016/j.ajp.2022.103097] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 03/19/2022] [Accepted: 04/02/2022] [Indexed: 01/08/2023]
Abstract
Due to its high prevalence and fatality, the current Severe Acute Respiratory Syndrome-coronavirus-2 (SARS-CoV-2) virus, which first emerged in China in 2019, quickly spread around the world and immediately became a serious global health concern. Although respiratory issues were initially the most prominent symptom of coronavirus disease 2019 (COVID-19), it became obvious rapidly that COVID-19, like many other coronavirus family members, could affect the central nervous system (CNS). During the pandemic, CNS involvement expressed itself in a variety of forms, including insomnia, anosmia, headaches, encephalopathies, encephalitis, cerebrovascular accidents, cognitive and memory impairment, and increased psychiatric disorders. Almost everyone who has been infected has at least one of these neurological symptoms, demonstrating that the virus has a high ability to impact the CNS. As the coronavirus pandemic passes its second year, the manifestations it can cause in the long run, such as its psychological sequels, have not yet been thoroughly studied. Given the high importance of this issue in today's society and due to the lack of reliable knowledge about the COVID-19 landscape on psychiatric disorders, we intend to investigate coronavirus's possible effect on mental illnesses based on available literature. Because the majority of the psychological effects of the coronavirus can continue for a long period after the pandemic ends, our research can give insight into potential psychiatric sequels associated with COVID-19.
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Affiliation(s)
- Ali Dehghani
- Department of Medical Genetics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Elham Zokaei
- Department of Biology, Faculty of Science, Shahid Bahonar University of Kerman, Kerman, Iran
| | - Seyyed Mohammad Kahani
- Department of Medical Genetics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Elaheh Alavinejad
- Department of Medical Genetics, Faculty of Medical Sciences, Tehran University of Medical Science, Tehran, Iran
| | - Mohammad Dehghani
- Department of Pathology and Stem Cell Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Mohammad Reza Afarinesh
- Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran.
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Palladini M, Bravi B, Colombo F, Caselani E, Di Pasquasio C, D'Orsi G, Rovere-Querini P, Poletti S, Benedetti F, Mazza MG. Cognitive remediation therapy for post-acute persistent cognitive deficits in COVID-19 survivors: A proof-of-concept study. Neuropsychol Rehabil 2022:1-18. [PMID: 35583357 DOI: 10.1080/09602011.2022.2075016] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
ABSTRACTCognitive impairments figure prominently in COVID-19 survivors. Cognitive remediation therapy (CRT) improves functional outcomes reducing long-term cognitive deficits in several neurological and psychiatric conditions. Our case-control study investigates the efficacy of a CRT programme administered to COVID-19 survivors in the post-acute phase of the illness. Seventy-three COVID-19 survivors presenting cognitive impairments at one-month follow-up were enrolled. Among them, 15 patients were treated with a two-month CRT programme, and 30 non-treated patients were matched conditional to their baseline cognitive functioning. Cognitive functions were assessed before and after treatment. Depression and quality of life were also evaluated. Mixed model ANOVA revealed a significant effect over time of the CRT programme on global cognitive functioning (F = 4.56, p = 0.039), while no significant effect was observed in the untreated group. We observed a significant effect of the improvement in verbal fluency (χ2 = 7.20, p = 0.007) and executive functions (χ2 = 13.63, p < 0.001) on quality of life. A positive significant correlation was found between depressive symptomatology and verbal fluency (r = -0.35), working memory (r = -0.44), psychomotor coordination (r = -0.42), and executive functions (r = -0.33). Our results could pave the way to a plausible innovative treatment targeting cognitive impairments and ameliorating the quality of life of COVID-19 survivors.
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Affiliation(s)
- Mariagrazia Palladini
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy.,PhD Program in Cognitive Neuroscience, University Vita-Salute San Raffaele, Milan, Italy
| | - Beatrice Bravi
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy.,PhD Program in Cognitive Neuroscience, University Vita-Salute San Raffaele, Milan, Italy
| | - Federica Colombo
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy.,PhD Program in Cognitive Neuroscience, University Vita-Salute San Raffaele, Milan, Italy
| | - Elisa Caselani
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Camilla Di Pasquasio
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Greta D'Orsi
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Patrizia Rovere-Querini
- Vita-Salute San Raffaele University, Milano, Italy.,Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Sara Poletti
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy.,Vita-Salute San Raffaele University, Milano, Italy
| | - Francesco Benedetti
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy.,Vita-Salute San Raffaele University, Milano, Italy
| | - Mario Gennaro Mazza
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy.,PhD Program in Cognitive Neuroscience, University Vita-Salute San Raffaele, Milan, Italy
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Efstathiou V, Stefanou MI, Demetriou M, Siafakas N, Makris M, Tsivgoulis G, Zoumpourlis V, Kympouropoulos S, Tsoporis J, Spandidos D, Smyrnis N, Rizos E. Long COVID and neuropsychiatric manifestations (Review). Exp Ther Med 2022; 23:363. [PMID: 35493431 PMCID: PMC9019760 DOI: 10.3892/etm.2022.11290] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 03/24/2022] [Indexed: 12/02/2022] Open
Abstract
There is accumulating evidence in the literature indicating that a number of patients with coronavirus disease 2019 (COVID-19) may experience a range of neuropsychiatric symptoms, persisting or even presenting following the resolution of acute COVID-19. Among the neuropsychiatric manifestations more frequently associated with ‘long COVID’ are depression, anxiety, post-traumatic stress disorder, sleep disturbances, fatigue and cognitive deficits, that can potentially be debilitating and negatively affect patients' wellbeing, albeit in the majority of cases symptoms tend to improve over time. Despite variations in results obtained from studies using different methodological approaches to define ‘long COVID’ syndrome, the most widely accepted factors associated with a higher risk of developing neuropsychiatric manifestations include the severity of foregoing COVID-19, the female sex, the presence of comorbidities, a history of mental health disease and an elevation in the levels of inflammatory markers, albeit further research is required to establish causal associations. To date, the pathophysiological mechanisms implicated in neuropsychiatric manifestations of ‘long COVID’ remain only partially elucidated, while the role of the indirect effects of the COVID-19 pandemic, such as social isolation and uncertainty concerning social, financial and health recovery post-COVID, have also been highlighted. Given the alarming effects of ‘long-COVID’, interdisciplinary cooperation for the early identification of patients who are at a high risk of persistent neuropsychiatric presentations, beyond COVID-19 recovery, is crucial to ensure that appropriate integrated physical and mental health support is provided, with the aim of mitigating the risks of long-term disability at a societal and individual level.
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Affiliation(s)
- Vasiliki Efstathiou
- Second Department of Psychiatry, National and Kapodistrian University of Athens, ‘Attikon’ University General Hospital, Athens 12462, Greece
| | - Maria-Ioanna Stefanou
- Second Department of Neurology, National and Kapodistrian University of Athens, ‘Attikon’ University General Hospital, Athens 12462, Greece
| | - Marina Demetriou
- Second Department of Psychiatry, National and Kapodistrian University of Athens, ‘Attikon’ University General Hospital, Athens 12462, Greece
| | - Nikolaos Siafakas
- Clinical Microbiology Laboratory, National and Kapodistrian University of Athens, ‘Attikon’ University General Hospital, Athens 12462, Greece
| | - Michael Makris
- Allergy Unit, Second Department of Dermatology and Venereology, Medical School, National and Kapodistrian University of Athens, ‘Attikon’ University General Hospital, Athens 12462, Greece
| | - Georgios Tsivgoulis
- Second Department of Neurology, National and Kapodistrian University of Athens, ‘Attikon’ University General Hospital, Athens 12462, Greece
| | - Vassilios Zoumpourlis
- Biomedical Applications Unit, Institute of Chemical Biology, National Hellenic Research Foundation (NHRF), Athens 11635, Greece
| | - Stylianos Kympouropoulos
- Second Department of Psychiatry, National and Kapodistrian University of Athens, ‘Attikon’ University General Hospital, Athens 12462, Greece
| | - James Tsoporis
- Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, ON M5B 1W8, Canada
| | - Demetrios Spandidos
- Laboratory of Clinical Virology, Medical School, University of Crete, Heraklion 71003, Greece
| | - Nikolaos Smyrnis
- Second Department of Psychiatry, National and Kapodistrian University of Athens, ‘Attikon’ University General Hospital, Athens 12462, Greece
| | - Emmanouil Rizos
- Second Department of Psychiatry, National and Kapodistrian University of Athens, ‘Attikon’ University General Hospital, Athens 12462, Greece
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Depressive symptoms, but not anxiety, predict subsequent diagnosis of Coronavirus disease 19: a national cohort study. Epidemiol Psychiatr Sci 2022; 31:e16. [PMID: 35331365 PMCID: PMC8967696 DOI: 10.1017/s2045796021000676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
AIMS Several diseases are linked to increased risk of Coronavirus disease 19 (COVID-19). Our aim was to investigate whether depressive and anxiety symptoms predict subsequent risk of COVID-19, as has been shown for other respiratory infections. METHODS We based our analysis on UK Biobank participants providing prospective data to estimate temporal association between depressive and anxiety symptoms and COVID-19. We estimated whether the magnitude of these symptoms predicts subsequent diagnosis of COVID-19 in this sample. Further, we evaluated whether depressive and anxiety symptoms predicted (i) being tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and (ii) COVID-19 in those tested. RESULTS Based on data from N = 135 102 participants, depressive symptoms (odds ratio (OR) = 1.052; 95% confidence interval (CI) 1.017-1.086; absolute case risk: (moderately) severe depression: 493 per 100 000 v. minimal depression: 231 per 100 000) but not anxiety (OR = 1.009; 95% CI 0.97-1.047) predicted COVID-19. While depressive symptoms but not anxiety predicted (i) being tested for SARS-CoV-2 (OR = 1.039; 95% CI 1.029-1.05 and OR = 0.99; 95% CI 0.978-1.002), (ii) neither predicted COVID-19 in those tested (OR = 1.015; 95% CI 0.981-1.05 and OR = 1.021; 95% CI 0.981-1.061). Results remained stable after adjusting for sociodemographic characteristics, multimorbidity and behavioural factors. CONCLUSIONS Depressive symptoms were associated with a higher risk of COVID-19 diagnosis, irrespective of multimorbidities. Potential underlying mechanisms to be elucidated include risk behaviour, symptom perception, healthcare use, testing likelihood, viral exposure, immune function and disease progress. Our findings highlight the relevance of mental processes in the context of COVID-19.
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Tuna Ö, Ermis C, Enez Darcin A, Dagistan E, Salman S. Comparison of inflammation markers and severity of illness among patients with COVID-19, acute psychiatric disorders and comorbidity. THE EUROPEAN JOURNAL OF PSYCHIATRY 2022; 37:125-132. [PMID: 35125586 PMCID: PMC8806143 DOI: 10.1016/j.ejpsy.2022.01.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 01/26/2022] [Indexed: 11/19/2022]
Abstract
Background and objectives Neutrophil, lymphocyte counts, lactate dehydrogenase (LDH), D-dimer, fibrinogen, and comorbid illness are associated with the course and prognosis of COVID-19. However, the course of acute severe psychiatric disorders overlapping with COVID-19 infection was not investigated and remained as an unclarified research area. This study aimed to demonstrate inflammatory markers and the course of patients suffering from both conditions. Methods Thirty-eight inpatients with COVID-19 and comorbid acute psychiatric disorders (COVID-19+PD), 31 inpatients with COVID-19, and 38 inpatients with an acute psychiatric disorder (PD) were included in the study. Neutrophil, lymphocyte counts, serum ferritin, lactate dehydrogenase (LDH), D-dimer, fibrinogen, Systemic immune-inflammation index (SII), neutrophil/lymphocyte ratio (NLR), and C-reactive protein (CRP) were compared to evaluate inflammation levels. Results Patients with SARS-CoV-2 infection had older age compared to the PD group. CALL (Comorbidity, age, lymphocyte, lactate dehydrogenase) scores which predict the progression risk in patients with COVID-19 pneumonia, of both COVID-19 groups were found similar. The COVID-19+PD had higher SII in the study sample. Additionally, the COVID-19+PD group had higher NLR, ferritin, and CRP levels than those of the PD group. Conclusions The prognosis of COVID-19 is not worse when accompanied by a psychiatric disorder. Laboratory assessment can guide clinicians to distinguish those infected with SARS-CoV-2 within psychiatric inpatient units. The biochemical assessment did not robustly support higher inflammatory levels in the comorbid COVID-19 and psychiatric disorder group compared to the COVID-19 group.
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Affiliation(s)
- Özgecan Tuna
- Department of Psychiatry, Kanuni Sultan Süleyman Training and Research Hospital, Turkey
| | - Cagatay Ermis
- Department of Child and Adolescent Psychiatry, Diyarbakır Childrens' Hospital, Turkey
| | | | - Ekin Dagistan
- Department of Psychiatry, Istanbul Bakirkoy Prof Dr. Mazhar Osman Ruh Mental and Nervous Diseases Training and Research Hospital, Turkey
| | - Serdar Salman
- Department of Psychiatry, Istanbul Bakirkoy Prof Dr. Mazhar Osman Ruh Mental and Nervous Diseases Training and Research Hospital, Turkey
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Kim J, Seo YE, Sung HK, Park HY, Han MH, Lee SH. Predictors of the Development of Mental Disorders in Hospitalized COVID-19 Patients without Previous Psychiatric History: A Single-Center Retrospective Study in South Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031092. [PMID: 35162116 PMCID: PMC8834137 DOI: 10.3390/ijerph19031092] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/14/2022] [Accepted: 01/17/2022] [Indexed: 12/04/2022]
Abstract
The objective of this study was to investigate the predictors for new-onset mental disorders among patients with mild to moderate COVID-19 illness during hospitalization. A retrospective cohort study was performed in patients with confirmed COVID-19 admitted to a nationally designated hospital between 1 February and 30 June 2020. Demographic, clinical, psychological assessments, and psychiatric outcomes were obtained from electronic medical record review. Multivariate logistic regression analysis was used to identify predictors of new-onset mental disorders. Among 185 patients, 130 had no history of mental disorders or cognitive impairment at the time of admission. Of 130 patients, 29 (22.3%) were newly diagnosed with mental disorders during hospitalization. The following factors were significantly associated with an increased risk of a psychiatric diagnosis: Charlson comorbidity index core ≥1 (adjusted odds ratio (aOR) = 5.115, 95% confidence interval (CI): 1.737–15.058), length of stay (aOR per 1-day increase = 1.067, 95% CI: 1.035–1.100), and self-reported depressive symptoms at the time of admission (aOR = 5.357, 95% CI: 1.745–16.444). The predictive accuracy of combining these risk factors was relatively high (area under curve = 0.851, 95% CI: 0.778–0.923). These potential risk factors could help to predict the new-onset mental disorder among hospitalized patients with COVID-19.
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Affiliation(s)
- Jangrae Kim
- Department of Psychiatry, National Medical Center, Eulji-ro 245, Jung-gu, Seoul 04564, Korea; (J.K.); (Y.E.S.); (M.H.H.)
| | - Yae Eun Seo
- Department of Psychiatry, National Medical Center, Eulji-ro 245, Jung-gu, Seoul 04564, Korea; (J.K.); (Y.E.S.); (M.H.H.)
| | - Ho Kyung Sung
- Institute for Public Healthcare, National Medical Center, Eulji-ro 245, Jung-gu, Seoul 04564, Korea
- National Emergency Medical Center, National Medical Center, Eulji-ro 245, Jung-gu, Seoul 04564, Korea
- Correspondence: (H.K.S.); (S.H.L.); Tel.: +82-2-6362-3487 (H.K.S.); +82-2-2260-7311 (S.H.L.); Fax: +82-2-2267-8685 (H.K.S.); +82-2-2268-5028 (S.H.L.)
| | - Hye Yoon Park
- Department of Psychiatry, Seoul National University Hospital, Daehak-ro 101, Jongno-gu, Seoul 03080, Korea;
- Department of Psychiatry, Seoul National University College of Medicine, Daehak-ro 103, Jongno-gu, Seoul 03080, Korea
| | - Myung Hwa Han
- Department of Psychiatry, National Medical Center, Eulji-ro 245, Jung-gu, Seoul 04564, Korea; (J.K.); (Y.E.S.); (M.H.H.)
| | - So Hee Lee
- Department of Psychiatry, National Medical Center, Eulji-ro 245, Jung-gu, Seoul 04564, Korea; (J.K.); (Y.E.S.); (M.H.H.)
- Correspondence: (H.K.S.); (S.H.L.); Tel.: +82-2-6362-3487 (H.K.S.); +82-2-2260-7311 (S.H.L.); Fax: +82-2-2267-8685 (H.K.S.); +82-2-2268-5028 (S.H.L.)
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Durnaoglu S, Lee SK, Ahnn J. Syncytin, envelope protein of human endogenous retrovirus (HERV): no longer 'fossil' in human genome. Anim Cells Syst (Seoul) 2022; 25:358-368. [PMID: 35059135 PMCID: PMC8765258 DOI: 10.1080/19768354.2021.2019109] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 12/07/2021] [Indexed: 12/17/2022] Open
Abstract
Human endogenous retroviruses (HERVs) are 'fossil viruses' that resulted from stable integrations of exogenous retroviruses throughout evolution. HERVs are defective and do not produce infectious viral particles. However, some HERVs retain a limited coding capacity and produce retroviral transcripts and proteins, which function in human developmental process and various pathologies, including many cancers and neurological diseases. Recently, it has been reported that HERVs are differently expressed in COVID-19 disease caused by infection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In this review, we discuss the molecular structure and function of HERV ENV proteins, particularly syncytins, and their conventional roles in human development and diseases, and potential involvement in COVID-19 regarding the newly reported mental symptoms. We also address COVID-19 vaccine-related infertility concerns arising from the similarity of syncytin with the spike protein of SARS-CoV-2, which have been proved invalid.
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Affiliation(s)
- Serpen Durnaoglu
- College of Natural Sciences, Hanyang University, Seoul, Republic of Korea
- Research Institute for Natural Sciences, College of Natural Sciences, Hanyang University, Seoul, Republic of Korea
| | - Sun-Kyung Lee
- College of Natural Sciences, Hanyang University, Seoul, Republic of Korea
- Research Institute for Natural Sciences, College of Natural Sciences, Hanyang University, Seoul, Republic of Korea
| | - Joohong Ahnn
- College of Natural Sciences, Hanyang University, Seoul, Republic of Korea
- Research Institute for Natural Sciences, College of Natural Sciences, Hanyang University, Seoul, Republic of Korea
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Psychological Symptoms in COVID-19 Patients: Insights into Pathophysiology and Risk Factors of Long COVID-19. BIOLOGY 2022; 11:biology11010061. [PMID: 35053059 PMCID: PMC8773222 DOI: 10.3390/biology11010061] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 12/26/2021] [Accepted: 12/27/2021] [Indexed: 12/17/2022]
Abstract
There is growing evidence of studies associating COVID-19 survivors with increased mental health consequences. Mental health implications related to a COVID-19 infection include both acute and long-term consequences. Here we discuss COVID-19-associated psychiatric sequelae, particularly anxiety, depression, and post-traumatic stress disorder (PTSD), drawing parallels to past coronavirus outbreaks. A literature search was completed across three databases, using keywords to search for relevant articles. The cause may directly correlate to the infection through both direct and indirect mechanisms, but the underlying etiology appears more complex and multifactorial, involving environmental, psychological, and biological factors. Although most risk factors and prevalence rates vary across various studies, being of the female gender and having a history of psychiatric disorders seem consistent. Several studies will be presented, demonstrating COVID-19 survivors presenting higher rates of mental health consequences than the general population. The possible mechanisms by which the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) enters the brain, affecting the central nervous system (CNS) and causing these psychiatric sequelae, will be discussed, particularly concerning the SARS-CoV-2 entry via the angiotensin-converting enzyme 2 (ACE-2) receptors and the implications of the immune inflammatory signaling on neuropsychiatric disorders. Some possible therapeutic options will also be considered.
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Rapid response to selective serotonin reuptake inhibitors in post-COVID depression. Eur Neuropsychopharmacol 2022; 54:1-6. [PMID: 34634679 PMCID: PMC8500775 DOI: 10.1016/j.euroneuro.2021.09.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 09/20/2021] [Accepted: 09/22/2021] [Indexed: 12/17/2022]
Abstract
The spreading of the Severe Acute Respiratory Syndrome Coronavirus (COVID-19) pandemic could be associated with psychiatric implications. After COVID-19, depression was reported in 40% of patients at one-, three-, and six-months follow-up. Emerging literature suggests anti-inflammatory and antiviral properties of antidepressants in the treatment of SARS-CoV-2. We aim to investigate the efficacy of Selective Serotonin Reuptake Inhibitor (SSRI) in treating post-COVID depression. We included 60 patients affected by a major depressive episode and treated with SSRI in the six months following recovery from COVID. The severity of depression was rated at baseline and after four weeks on the Hamilton Depression Rating Scale (HDRS). Response to treatment was considered when the patients achieved a 50% HDRS reduction. To investigate changes of depressive symptomatology over time, repeated measures ANOVAs according to clinical variables were performed. We found that 55 (92%) patients showed a clinical response to antidepressant. Patients showed a significant decrease over time of HDRS score (baseline HDRS = 23.37 ± 3.94, post-treatment HDRS = 6.71±4.41, F = 618.90, p < 0.001), irrespectively of sex, previous psychiatric history, previous history of mood disorder, and SSRI type. This is the first study to explore the SSRI efficacy in post-COVID depression, suggesting rapid antidepressant effects in most patients. SSRIs treatment could contribute to the rapid antidepressant response by directly targeting the neuroinflammation triggered by SARS-CoV-2. We suggest screening psychopathology of COVID-19 survivors to diagnose emergent depression and pharmacologically treat it to reduce the disease burden and related years of life lived with disability.
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Shahrajabian MH. Powerful Stress Relieving Medicinal Plants for Anger, Anxiety, Depression, and Stress During Global Pandemic. Recent Pat Biotechnol 2022; 16:284-310. [PMID: 35319401 DOI: 10.2174/1872208316666220321102216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 10/01/2021] [Accepted: 12/08/2021] [Indexed: 06/14/2023]
Abstract
Consideration and improvement for anxiety and depression are important during a global pandemic. Appropriate healthcare can be obtained by paying more attention to traditional medicinal sciences. The adverse effects of stress with various symptoms can be managed by introducing plants that boost mental health. The most relevant psychological reactions in the general population related to the global pandemic are pervasive anxiety, frustration and boredom, specific and uncontrolled fear, disabling loneliness, significant lifestyle changes, and psychiatric conditions. Ginseng, chamomile, passionflower, herbal tea, lavender, saffron, kava, rose, cardamom, Chinese date, and some chief formula like yokukansan, Dan-zhi-xiao-yao-san, so-ochim-tang-gamiband, and saikokaryukotsuboreito are notable herbal treatments for mental health problems. The most common medicinal plants that have been used in Iran for the cure of stress and anxiety are Viper's-buglosses, Dracocephalum, valerian, chamomile, common hop, hawthorns, and lavender. Medicinal plants and herbs can be used for the treatment and alleviation of the negative effects of stress, anger, and depression during the global pandemic.
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Mazza MG, Palladini M, Poletti S, Benedetti F. Post-COVID-19 Depressive Symptoms: Epidemiology, Pathophysiology, and Pharmacological Treatment. CNS Drugs 2022; 36:681-702. [PMID: 35727534 PMCID: PMC9210800 DOI: 10.1007/s40263-022-00931-3] [Citation(s) in RCA: 78] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/19/2022] [Indexed: 12/12/2022]
Abstract
The Coronavirus Disease 2019 (COVID-19) pandemic is still spreading worldwide over 2 years since its outbreak. The psychopathological implications in COVID-19 survivors such as depression, anxiety, and cognitive impairments are now recognized as primary symptoms of the "post-acute COVID-19 syndrome." Depressive psychopathology was reported in around 35% of patients at short, medium, and long-term follow-up after the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection. Post-COVID-19 depressive symptoms are known to increase fatigue and affect neurocognitive functioning, sleep, quality of life, and global functioning in COVID-19 survivors. The psychopathological mechanisms underlying post-COVID-19 depressive symptoms are mainly related to the inflammation triggered by the peripheral immune-inflammatory response to the viral infection and to the persistent psychological burden during and after infection. The large number of SARS-CoV-2-infected patients and the high prevalence of post-COVID-19 depressive symptoms may significantly increase the pool of people suffering from depressive disorders. Therefore, it is essential to screen, diagnose, treat, and monitor COVID-19 survivors' psychopathology to counteract the depression disease burden and related years of life lived with disability. This paper reviews the current literature in order to synthesize the available evidence regarding epidemiology, clinical features, neurobiological underpinning, and pharmacological treatment of post-COVID-19 depressive symptoms.
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Affiliation(s)
- Mario Gennaro Mazza
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, San Raffaele Turro, Via Stamira d'Ancona 20, 20127, Milan, Italy. .,Vita-Salute San Raffaele University, Milan, Italy. .,PhD Program in Cognitive Neuroscience, Vita-Salute San Raffaele University, Milan, Italy.
| | - Mariagrazia Palladini
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, San Raffaele Turro, Via Stamira d’Ancona 20, 20127 Milan, Italy ,grid.15496.3f0000 0001 0439 0892Vita-Salute San Raffaele University, Milan, Italy ,grid.15496.3f0000 0001 0439 0892PhD Program in Cognitive Neuroscience, Vita-Salute San Raffaele University, Milan, Italy
| | - Sara Poletti
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, San Raffaele Turro, Via Stamira d’Ancona 20, 20127 Milan, Italy ,grid.15496.3f0000 0001 0439 0892Vita-Salute San Raffaele University, Milan, Italy
| | - Francesco Benedetti
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, San Raffaele Turro, Via Stamira d’Ancona 20, 20127 Milan, Italy ,grid.15496.3f0000 0001 0439 0892Vita-Salute San Raffaele University, Milan, Italy
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Benedetti F, Palladini M, Paolini M, Melloni E, Vai B, De Lorenzo R, Furlan R, Rovere-Querini P, Falini A, Mazza MG. Brain correlates of depression, post-traumatic distress, and inflammatory biomarkers in COVID-19 survivors: A multimodal magnetic resonance imaging study. Brain Behav Immun Health 2021; 18:100387. [PMID: 34746876 PMCID: PMC8562046 DOI: 10.1016/j.bbih.2021.100387] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 10/31/2021] [Indexed: 01/08/2023] Open
Abstract
Psychiatric sequelae substantially contribute to the post-acute burden of disease associated with COVID-19, persisting months after clearance of the virus. Brain imaging shows white matter (WM) hypodensities/hyperintensities, and the involvement of grey matter (GM) in prefrontal, anterior cingulate (ACC) and insular cortex after COVID, but little is known about brain correlates of persistent psychopathology. With a multimodal approach, we studied whole brain voxel-based morphometry, diffusion-tensor imaging, and resting-state connectivity, to correlate MRI measures with depression and post-traumatic distress (PTSD) in 42 COVID-19 survivors without brain lesions, at 90.59 ± 54.66 days after COVID. Systemic immune-inflammation index (SII) measured in the emergency department, which reflects the immune response and systemic inflammation based on peripheral lymphocyte, neutrophil, and platelet counts, predicted worse self-rated depression and PTSD, widespread lower diffusivity along the main axis of WM tracts, and abnormal functional connectivity (FC) among resting state networks. Self-rated depression and PTSD inversely correlated with GM volumes in ACC and insula, axial diffusivity, and associated with FC. We observed overlapping associations between severity of inflammation during acute COVID-19, brain structure and function, and severity of depression and post-traumatic distress in survivors, thus warranting interest for further study of brain correlates of the post-acute COVID-19 syndrome. Beyond COVID-19, these findings support the hypothesis that regional GM, WM microstructure, and FC could mediate the relationship between a medical illness and its psychopathological sequelae, and are in agreement with current perspectives on the brain structural and functional underpinnings of depressive psychopathology.
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Affiliation(s)
- Francesco Benedetti
- Vita-Salute San Raffaele University, Milano, Italy
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Mariagrazia Palladini
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Marco Paolini
- Vita-Salute San Raffaele University, Milano, Italy
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
- PhD Program in Molecular Medicine, University Vita-Salute San Raffaele, Milan, Italy
| | - Elisa Melloni
- Vita-Salute San Raffaele University, Milano, Italy
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Benedetta Vai
- Vita-Salute San Raffaele University, Milano, Italy
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Rebecca De Lorenzo
- Vita-Salute San Raffaele University, Milano, Italy
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS Scientific Institute Ospedale San Raffaele, Milan, Italy
| | - Roberto Furlan
- Clinical Neuroimmunology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Patrizia Rovere-Querini
- Vita-Salute San Raffaele University, Milano, Italy
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS Scientific Institute Ospedale San Raffaele, Milan, Italy
| | - Andrea Falini
- Vita-Salute San Raffaele University, Milano, Italy
- Department of Neuroradiology, IRCCS Scientific Institute Ospedale San Raffaele, Milan, Italy
| | - Mario Gennaro Mazza
- Vita-Salute San Raffaele University, Milano, Italy
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
- PhD Program in Cognitive Neuroscience, University Vita-Salute San Raffaele, Milan, Italy
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Dorri M, Mozafari Bazargany MH, Khodaparast Z, Bahrami S, Seifi Alan M, Rahimi F, Kamipoor Z, Niksima MM, Dehghan H, Rastad H. Psychological problems and reduced health-related quality of life in the COVID-19 survivors. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021; 6:100248. [PMID: 34642678 PMCID: PMC8495058 DOI: 10.1016/j.jadr.2021.100248] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 09/23/2021] [Accepted: 10/01/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND COVID-19 survivors are predicted to experience the long-term consequences, including pulmonary, neurologic, cardiovascular, and mental health sequelae. This systematic review and meta-analysis was performed on studies assessing the health-related quality of life (HRQoL) and psychiatric problems in COVID-19 survivors. METHODS A systematic search was performed on PubMed, Embase, and Google scholar databases using key terms COVID-19, PTSD, depression, anxiety, HRQoL, survivors. Pooled estimates were calculated using the random-effects models. RESULTS A total of 21 eligible articles were included. The pooled prevalence of PTSD, depression, and anxiety among COVID-19 survivors were 18% (95% CI: 13 to 23%, I2=88.23%), 12% (8 to 17%, I2=91.84%), and 17% (12 to 22%, I2=97.07%), respectively. COVID-19 survivors compared to pre-COVID-19 time and controls showed reduced HRQoL and a lower score in Social Functioning (SF) and Role Physical (RP), and Role Emotional (RE) health. Females compared to males had a higher risk of experiencing mental health problems. Also, patients with severe disease had a higher prevalence of depression and anxiety, but not PTSD. LIMITATIONS Regarding HRQoL, we were not able to perform a subgroup analysis due to a lack of data. Also, the included studies mainly used a self-rating scale to detect psychological problems in their study population. CONCLUSION A significant number of patients who survived from COVID-19 might suffer from PTSD, depression, and anxiety beyond one month. Our systematic review also found evidence of reduced HQOL and limited social role in these survivors.
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Affiliation(s)
- Mahya Dorri
- Cardiovascular Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | | | - Zeinab Khodaparast
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Soroush Bahrami
- Cardiovascular Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Mahnaz Seifi Alan
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Fariba Rahimi
- Cardiovascular Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Zeinab Kamipoor
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Mohammad Mahdi Niksima
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Hanieh Dehghan
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Hadis Rastad
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
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Uhr L, Rice DR, Mateen FJ. Sociodemographic and clinical factors associated with depression, anxiety, and general mental health in people with multiple sclerosis during the COVID-19 pandemic. Mult Scler Relat Disord 2021; 56:103327. [PMID: 34666242 PMCID: PMC8523026 DOI: 10.1016/j.msard.2021.103327] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 09/06/2021] [Accepted: 10/10/2021] [Indexed: 02/08/2023]
Abstract
Background People with multiple sclerosis (PwMS) may be at increased risk for psychological distress during COVID-19. We study the self-reported mental health of U.S. PwMS during COVID-19, prior to vaccine rollout. Methods A cross-sectional survey was distributed online to PwMS through iConquerMS (12/18/2020-02/10/2021). Depressive and anxiety symptom burdens and general mental health status were measured via the Patient-Health Questionnaire-9, Generalized Anxiety Disorder-7, and PROMIS Global Mental Health scales. Linear regression models assessed associations between mental health variables and age, sex, disability status, comorbidities, and social determinants of health. Results Of 610 U.S. PwMS (mean age 56 years, standard deviation 11, range 20-85; female, 81%; relapsing remitting disease, 62%; previous depression diagnosis, 40%), the prevalences of moderate-to-severe depressive and anxiety symptom burden were 27.4% and 14.7%, respectively; 55.1% endorsed fair/poor general mental health. PwMS who tested positive for COVID-19 (n = 47, 7.7%) reported higher depressive and anxiety symptom burdens (p < 0.05). Increased disability status score and social determinants of health were each associated with more depressive symptoms and worse general mental health. Younger age was associated with increased depressive and anxiety symptom burdens and worse general mental health. Female sex was associated with greater anxiety symptoms. Conclusion There are specific associations for worse mental health among PwMS during COVID-19 that reflect a combination of clinical, demographic, and social determinants of health. Multidisciplinary care teams and vigilance are important to address the ongoing mental health impacts of COVID-19 in PwMS.
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Affiliation(s)
- Lauren Uhr
- David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Dylan R Rice
- Department of Neurology, Massachusetts General Hospital, 165 Cambridge Street, #627, Boston, MA 02114, United States
| | - Farrah J Mateen
- Department of Neurology, Massachusetts General Hospital, 165 Cambridge Street, #627, Boston, MA 02114, United States.
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Schou TM, Joca S, Wegener G, Bay-Richter C. Psychiatric and neuropsychiatric sequelae of COVID-19 - A systematic review. Brain Behav Immun 2021; 97:328-348. [PMID: 34339806 PMCID: PMC8363196 DOI: 10.1016/j.bbi.2021.07.018] [Citation(s) in RCA: 225] [Impact Index Per Article: 75.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 07/22/2021] [Accepted: 07/24/2021] [Indexed: 12/12/2022] Open
Abstract
It has become evident that coronavirus disease 2019 (COVID-19) has a multi-organ pathology that includes the brain and nervous system. Several studies have also reported acute psychiatric symptoms in COVID-19 patients. An increasing number of studies are suggesting that psychiatric deficits may persist after recovery from the primary infection. In the current systematic review, we provide an overview of the available evidence and supply information on potential risk factors and underlying biological mechanisms behind such psychiatric sequelae. We performed a systematic search for psychiatric sequelae in COVID-19 patients using the databases PubMed and Embase. Included primary studies all contained information on the follow-up period and provided quantitative measures of mental health. The search was performed on June 4th 2021. 1725 unique studies were identified. Of these, 66 met the inclusion criteria and were included. Time to follow-up ranged from immediately after hospital discharge up to 7 months after discharge, and the number of participants spanned 3 to 266,586 participants. Forty studies reported anxiety and/or depression, 20 studies reported symptoms- or diagnoses of post-traumatic stress disorder (PTSD), 27 studies reported cognitive deficits, 32 articles found fatigue at follow-up, and sleep disturbances were found in 23 studies. Highlighted risk factors were disease severity, duration of symptoms, and female sex. One study showed brain abnormalities correlating with cognitive deficits, and several studies reported inflammatory markers to correlate with symptoms. Overall, the results from this review suggest that survivors of COVID-19 are at risk of psychiatric sequelae but that symptoms generally improve over time.
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Affiliation(s)
- Thor Mertz Schou
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark
| | - Samia Joca
- Department of Biomedicine, Aarhus University, 8000 Aarhus C, Denmark
| | - Gregers Wegener
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark
| | - Cecilie Bay-Richter
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark.
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Huarcaya-Victoria J, Barreto J, Aire L, Podestá A, Caqui M, Guija-Igreda R, Castillo C, Alarcon-Ruiz CA. Mental Health in COVID-2019 Survivors from a General Hospital in Peru: Sociodemographic, Clinical, and Inflammatory Variable Associations. Int J Ment Health Addict 2021; 21:1264-1285. [PMID: 34602915 PMCID: PMC8478369 DOI: 10.1007/s11469-021-00659-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/16/2021] [Indexed: 12/24/2022] Open
Abstract
The current coronavirus disease-2019 (COVID-19) pandemic constitutes a significant public health problem worldwide, as well as mental health problems. This study aimed to evaluate the mental health of COVID-19 survivors, considering their sociodemographic, clinical, and immune variables. A cross-sectional and correlational study was conducted on 318 COVID-19 survivors from one hospital in Peru. Through telephone interviews, evaluation of the presence of depressive symptoms using the Patient Health Questionnaire-9, anxiety symptoms through the Generalized Anxiety Disorder-7, somatic symptoms through Patient Health Questionnaire-15, and posttraumatic stress disorder (PTSD) symptoms through Impact of Event Scale-Revised was carried out. Poisson regression analyses were performed with their adjusted variances to calculate the prevalence ratio (PR) with their 95% confidence interval. All regression models were adjusted (PRa) for follow-up time. A significant proportion of patients have depressive (30.9%), anxious (31.1%), somatic (35.2%), and PTSD (29.5%) symptoms. The variables associated with a higher frequency of clinically relevant mental symptoms were female sex, self-perception of greater COVID-19 severity, presence of persistent COVID-19 symptoms, loss of a family member due to COVID-19, and prior psychiatric diagnosis or treatment. In addition, the neutrophil-to-lymphocyte ratio was significantly higher in patients with clinically relevant symptoms of depression. COVID-19 survivors showed a high prevalence of negative mental symptoms. Our findings help to identify patients who are vulnerable and require psychiatric care.
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Affiliation(s)
- Jeff Huarcaya-Victoria
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Universidad San Ignacio de Loyola, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud
, Lima, Peru
- Departamento de Psiquiatría, Unidad de Psiquiatría de Enlace, EsSalud, Hospital Nacional Guillermo Almenara Irigoyen, Av. Grau 800, Lima, Peru
| | - Jessica Barreto
- Departamento de Psiquiatría, Unidad de Psiquiatría de Enlace, EsSalud, Hospital Nacional Guillermo Almenara Irigoyen, Av. Grau 800, Lima, Peru
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Facultad de Medicina de San Fernando
,
Universidad Nacional Mayor de San Marcos
, Lima, Peru
| | - Lucia Aire
- Departamento de Psiquiatría, Unidad de Psiquiatría de Enlace, EsSalud, Hospital Nacional Guillermo Almenara Irigoyen, Av. Grau 800, Lima, Peru
| | - Angela Podestá
- Departamento de Psiquiatría, Unidad de Psiquiatría de Enlace, EsSalud, Hospital Nacional Guillermo Almenara Irigoyen, Av. Grau 800, Lima, Peru
| | - Mónica Caqui
- Departamento de Psiquiatría, Unidad de Psiquiatría de Enlace, EsSalud, Hospital Nacional Guillermo Almenara Irigoyen, Av. Grau 800, Lima, Peru
| | - Rosa Guija-Igreda
- Departamento de Psiquiatría, Unidad de Psiquiatría de Enlace, EsSalud, Hospital Nacional Guillermo Almenara Irigoyen, Av. Grau 800, Lima, Peru
| | - Claudia Castillo
- Departamento de Psiquiatría, Unidad de Psiquiatría de Enlace, EsSalud, Hospital Nacional Guillermo Almenara Irigoyen, Av. Grau 800, Lima, Peru
| | - Christoper A. Alarcon-Ruiz
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Grupo de Investigacion Neurociencia, Efectividad Clínica y Salud Publica
,
Universidad Científica del Sur
, Lima, Peru
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Nakamura I, Itoi T, Inoue T. Case report of restless anal syndrome as restless legs syndrome variant after COVID-19. BMC Infect Dis 2021; 21:993. [PMID: 34556029 PMCID: PMC8460186 DOI: 10.1186/s12879-021-06683-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 09/13/2021] [Indexed: 12/21/2022] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) has a broad spectrum from respiratory and nasopharyngeal symptoms, cerebrovascular diseases, impaired consciousness, and skeletal muscle injury. Emerging evidence has indicated the neural spread of this novel coronavirus. Restless legs syndrome (RLS) is a common neurological, sensorimotor disorder, but highly under diagnosis disorder. Restless anal syndrome as restless legs syndrome variant associated with COVID-19 has been previously not published. We report a case presenting with restless anal syndrome following COVID-19. Case presentation Although a 77-year-old male with COVID-19 improved to normal respiratory function 21 days after admission and treatment of favipiravir 200 mg per day for 14 days and dexamethasone 6.6 mg per day for 5 days, the insomnia and anxiety symptoms remained. Several weeks after discharge, he gradually began to experience restless, deep anal discomfort, approximately 10 cm from the perineal region. The following features were observed in the anal region; urge to move is essential, with worsening with rest, improvement with exercise, and worsening at evening. Colonoscopy revealed internal haemorrhoids without other rectal lesions. Neurological findings including deep tendon reflex, perineum loss of sensory and spinal cord injury, revealed no abnormalities. Diabetes militias, kidney dysfunction and iron deficiency status were not confirmed. Family history of RLS and periodic limb movements were not observed. Clonazepam at 1.5 mg per day resulted in the alleviation restless anal discomfort. Conclusions We reported a case presenting with restless anal syndrome following affection of COVID-19 as restless legs syndrome variant. This case fulfilled 4 essential features of RLS, urge to move, worsening with rest, improvement with exercise, and worsening at evening. To date, no case of restless anal syndrome associated with COVID-19 has been previously published. This case report may reflect the associative impacts of COVID-19 on the neuropsychiatric state. The long-term outcomes of neuropsychiatric conditions should continue to be monitored.
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Affiliation(s)
- Itaru Nakamura
- Tokyo Medical University Hospital, Tokyo, Japan. .,Department of Infection Prevention and Control, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.
| | - Takao Itoi
- Tokyo Medical University Hospital, Tokyo, Japan
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Lorkiewicz P, Waszkiewicz N. Biomarkers of Post-COVID Depression. J Clin Med 2021; 10:4142. [PMID: 34575258 PMCID: PMC8470902 DOI: 10.3390/jcm10184142] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 09/04/2021] [Accepted: 09/10/2021] [Indexed: 02/06/2023] Open
Abstract
The COVID-19 pandemic is spreading around the world and 187 million people have already been affected. One of its after-effects is post-COVID depression, which, according to the latest data, affects up to 40% of people who have had SARS-CoV-2 infection. A very important issue for the mental health of the general population is to look for the causes of this complication and its biomarkers. This will help in faster diagnosis and effective treatment of the affected patients. In our work, we focused on the search for major depressive disorder (MDD) biomarkers, which are also present in COVID-19 patients and may influence the development of post-COVID depression. For this purpose, we searched PubMed, Scopus and Google Scholar scientific literature databases using keywords such as 'COVID-19', 'SARS-CoV-2', 'depression', 'post-COVID', 'biomarkers' and others. Among the biomarkers found, the most important that were frequently described are increased levels of interleukin 6 (IL-6), soluble interleukin 6 receptor (sIL-6R), interleukin 1 β (IL-1β), tumor necrosis factor α (TNF-α), interferon gamma (IFN-γ), interleukin 10 (IL-10), interleukin 2 (IL-2), soluble interleukin 2 receptor (sIL-2R), C-reactive protein (CRP), Monocyte Chemoattractant Protein-1 (MCP-1), serum amyloid a (SAA1) and metabolites of the kynurenine pathway, as well as decreased brain derived neurotrophic factor (BDNF) and tryptophan (TRP). The biomarkers identified by us indicate the etiopathogenesis of post-COVID depression analogous to the leading inflammatory hypothesis of MDD.
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Affiliation(s)
- Piotr Lorkiewicz
- Department of Psychiatry, Medical University of Bialystok, Plac Brodowicza 1, 16-070 Choroszcz, Poland;
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47
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Foroughi M, Gupta R, Ganguly A, Mirza J, Fotros A. Neuropsychiatric Manifestations of COVID-19: A Review. ADVANCES IN PSYCHIATRY AND BEHAVIORAL HEALTH 2021; 1:161-172. [PMID: 38620912 PMCID: PMC8351041 DOI: 10.1016/j.ypsc.2021.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Moein Foroughi
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY 11203, USA
| | - Rishab Gupta
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
| | - Amvrine Ganguly
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY 11203, USA
| | - Junaid Mirza
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY 11203, USA
| | - Aryandokht Fotros
- Department of Psychiatry and Human Behavior, Brown University, Providence, RI, USA
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Shanbehzadeh S, Tavahomi M, Zanjari N, Ebrahimi-Takamjani I, Amiri-Arimi S. Physical and mental health complications post-COVID-19: Scoping review. J Psychosom Res 2021; 147:110525. [PMID: 34051516 PMCID: PMC8133797 DOI: 10.1016/j.jpsychores.2021.110525] [Citation(s) in RCA: 138] [Impact Index Per Article: 46.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 05/16/2021] [Accepted: 05/17/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Several long-lasting health complications have been reported in previous coronavirus infections. Therefore, the aim of this study was to review studies that evaluated physical and mental health problems post-COVID-19. METHODS Articles for inclusion in this scoping review were identified by searching the PubMed, Scopus, Web of Science and Google Scholar databases for items dated from 1 January to 7 November 2020. Observational studies evaluating physical health (musculoskeletal symptoms, functional status) or mental health status with a follow-up period longer than 1 month after discharge or after the onset of symptoms were included. RESULTS This scoping review included 34 studies with follow-up periods of up to 3 months post-COVID-19. The most commonly reported physical health problems were fatigue (range 28% to 87%), pain (myalgia 4.5% to 36%), arthralgia (6.0% to 27%), reduced physical capacity (six-minute walking test range 180 to 561 m), and declines in physical role functioning, usual care and daily activities (reduced in 15% to 54% of patients). Common mental health problems were anxiety (range 6.5% to 63%), depression (4% to 31%) and post-traumatic stress disorder (12.1% to 46.9%). Greater fatigue, pain, anxiety and depression were reported in female patients and individuals admitted to intensive care. An overall lower quality of life was seen up to 3 months post-COVID-19. CONCLUSIONS This review highlights the presence of several physical and mental health problems up to 3 months post-COVID-19. The findings point to the need for comprehensive evaluation and rehabilitation post-COVID-19 to promote quality of life.
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Affiliation(s)
- Sanaz Shanbehzadeh
- Rehabilitation Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mahnaz Tavahomi
- Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
| | - Nasibeh Zanjari
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Ismail Ebrahimi-Takamjani
- Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Somayeh Amiri-Arimi
- Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Mazza MG, Palladini M, De Lorenzo R, Magnaghi C, Poletti S, Furlan R, Ciceri F, Rovere-Querini P, Benedetti F. Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: Effect of inflammatory biomarkers at three-month follow-up. Brain Behav Immun 2021; 94:138-147. [PMID: 33639239 PMCID: PMC7903920 DOI: 10.1016/j.bbi.2021.02.021] [Citation(s) in RCA: 262] [Impact Index Per Article: 87.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/28/2021] [Accepted: 02/22/2021] [Indexed: 12/11/2022] Open
Abstract
COVID-19 outbreak is associated with mental health implications during viral infection and at short-term follow-up. Data on psychiatric and cognitive sequelae at medium-term follow-up are still lacking. During an ongoing prospective cohort study, the psychopathological and cognitive status of 226 COVID-19 pneumonia survivors (149 male, mean age 58) were prospectively evaluated one and three months after hospital discharge. Psychiatric clinical interview, self-report questionnaires, and neuropsychological profiling of verbal memory, working memory, psychomotor coordination, executive functions, attention and information processing, and verbal fluency were performed. Three months after discharge from the hospital, 35.8% still self-rated symptoms in the clinical range in at least one psychopathological dimension. We observed persistent depressive symptomatology, while PTSD, anxiety, and insomnia decreased during follow-up. Sex, previous psychiatric history, and the presence of depression at one month affected the depressive symptomatology at three months. Regardless of clinical physical severity, 78% of the sample showed poor performances in at least one cognitive domain, with executive functions and psychomotor coordination being impaired in 50% and 57% of the sample. Baseline systemic immune-inflammation index (SII), which reflects the immune response and systemic inflammation based on peripheral lymphocyte, neutrophil, and platelet counts, predicted self-rated depressive symptomatology and cognitive impairment at three-months follow-up; and changes of SII predicted changes of depression during follow-up. Neurocognitive impairments associated with severity of depressive psychopathology, and processing speed, verbal memory and fluency, and psychomotor coordination were predicted by baseline SII. We hypothesize that COVID-19 could result in prolonged systemic inflammation that predisposes patients to persistent depression and associated neurocognitive dysfunction. The linkage between inflammation, depression, and neurocognition in patients with COVID-19 should be investigated in long-term longitudinal studies, to better personalize treatment options for COVID-19 survivors.
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Affiliation(s)
- Mario Gennaro Mazza
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy; Vita-Salute San Raffaele University, Milano, Italy.
| | - Mariagrazia Palladini
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Rebecca De Lorenzo
- Vita-Salute San Raffaele University, Milano, Italy,Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Cristiano Magnaghi
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Sara Poletti
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy,Vita-Salute San Raffaele University, Milano, Italy
| | - Roberto Furlan
- Vita-Salute San Raffaele University, Milano, Italy,Clinical Neuroimmunology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Fabio Ciceri
- Vita-Salute San Raffaele University, Milano, Italy,Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Patrizia Rovere-Querini
- Vita-Salute San Raffaele University, Milano, Italy,Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Francesco Benedetti
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy,Vita-Salute San Raffaele University, Milano, Italy
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Zhou Y, Ding H, Zhang Y, Zhang B, Guo Y, Cheung T, Hall BJ, Shi T, Xiang YT, Tang Y. Prevalence of poor psychiatric status and sleep quality among frontline healthcare workers during and after the COVID-19 outbreak: a longitudinal study. Transl Psychiatry 2021; 11:223. [PMID: 33859159 PMCID: PMC8047599 DOI: 10.1038/s41398-020-01190-w] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 12/01/2020] [Accepted: 12/15/2020] [Indexed: 02/02/2023] Open
Abstract
Poor psychiatric status and sleep quality were common among frontline healthcare workers (FHWs) during the outbreak of the 2019 novel coronavirus disease (COVID-19), but the change in these mental health outcomes overtime remained unknown. This study compared the psychiatric status and sleep quality of FHWs during and after the COVID-19 outbreak in China. FHWs who volunteered to work in Hubei province (the COVID-19 epicenter) were assessed at baseline during the COVID-19 outbreak and re-assessed when they returned to their place of origin (Liaoning province) after the COVID-19 outbreak. Participants' psychiatric status and sleep quality were measured with the Symptom CheckList-90 (SCL-90) and the Pittsburgh Sleep Quality Index (PSQI), respectively. A total of 494 FHWs was assessed at baseline and 462 at follow-up assessments. The prevalence of poor psychiatric status was 10.5% at baseline and increased to 14.9% at the follow-up assessment (P = 0.04). The corresponding figures of poor sleep quality at baseline and follow-up assessment were 16.4% and 27.9%, respectively (P < 0.001). Multiple logistic regression analysis found that severe fatigue (p = 0.003, OR = 1.266, 95% CI = 1.081-1.483), poor sleep quality (p < 0.001, OR = 1.283, 95% CI = 1.171-1.405), and history of pre-existing psychiatric disorders (p < 0.001, OR = 5.085, 95% CI = 2.144-12.06) were independently associated with higher odds of poor psychiatric status among the FHWs. Poor psychiatric status and sleep quality were common among FHWs during the COVID-19 outbreak, and the prevalence increased following their volunteer experiences. This suggests a critical need for longer-term psychological support for this subpopulation.
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Affiliation(s)
- Yifang Zhou
- grid.412636.4Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province China ,grid.412636.4Department of Geriatric Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province China
| | - Hailong Ding
- grid.412449.e0000 0000 9678 1884School of Public Health, China Medical University, Shenyang, Liaoning Province China
| | - Yifan Zhang
- grid.412636.4Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province China
| | - Baoyan Zhang
- grid.412636.4Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province China
| | - Yingrui Guo
- grid.412636.4Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province China
| | - Teris Cheung
- grid.16890.360000 0004 1764 6123School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Brian J. Hall
- grid.449457.fNew York University (Shanghai), Shanghai, China ,grid.137628.90000 0004 1936 8753School of Global Public Health, New York University, New York, NY USA
| | - Tieying Shi
- grid.452435.10000 0004 1798 9070Department of Nursing, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China. .,Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China. .,Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao SAR, China.
| | - Yanqing Tang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China. .,Department of Geriatric Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China.
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