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Nishihara T, Shibata M, Ohashi A, Hiyama K, Yamashita T, Kuroiwa M, Sudo N. The relation between vaccination status and referral to a consultation-liaison psychiatry service for hospitalized patients with COVID-19. Biopsychosoc Med 2023; 17:40. [PMID: 37968660 PMCID: PMC10647145 DOI: 10.1186/s13030-023-00296-z] [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: 03/02/2023] [Accepted: 11/07/2023] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND Previous studies have shown that patients with Coronavirus Disease 2019 (COVID-19) are likely to be affected by delirium and other psychiatric complications. We aimed to evaluate the relation between COVID-19 vaccination status and referral of patients hospitalized with COVID-19 for consultation-liaison psychiatry services. METHOD From the medical records used for this retrospective, single hospital-based study, 576 patients were identified who were over 18 years-of-age and hospitalized with a diagnosis of COVID-19 between March 2020 and March 2022. The data of 531 for whom the vaccine history was obtained from the medical records were available for analysis: 455 without and 76 with referral to consultation-liaison psychiatry. A history of COVID-19 vaccination at least two times was used in the analysis of the odds for referral to liaison psychiatric consultation: 95% confidence interval (CI) in multivariable logistic regression. The adjustment factors included sex, age, body mass index (BMI), severity of COVID-19, C-reactive protein level, medical history, and therapeutic factors such as the use of remdesivir, steroids, or mechanical ventilation. RESULTS The prevalence of psychiatric consultation was 14.3%. Patients without vaccination had a 7-times greater OR (95%CI:2.08-23.58) than vaccinated patients for a referral for consultation-liaison psychiatry services after adjusting for confounding factors. CONCLUSION Non-vaccination was associated with a greater likelihood of referral for consultation-liaison psychiatry service among these hospitalized Japanese patients with COVID-19, even after adjusting for clinical and therapeutic factors. It is possible that vaccination greatly lessens the need for the referral of COVID-19 patients for consultation-liaison psychiatry services.
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Affiliation(s)
- Tomoe Nishihara
- Department of Psychosomatic Medicine, National Hospital Organization Fukuoka Higashi Medical Center, Fukuoka, Japan.
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
- Clinical Education Center, Kyushu University Hospital, Fukuoka, Japan.
| | - Mao Shibata
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Ayako Ohashi
- Department of Psychiatry, National Hospital Organization Fukuoka Higashi Medical Center, Fukuoka, Japan
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kazutoshi Hiyama
- Department of Infectious Disease, National Hospital Organization Fukuoka Higashi Medical Center, Fukuoka, Japan
| | - Takafumi Yamashita
- Department of Respiratory Medicine, National Hospital Organization Fukuoka Higashi Medical Center, Fukuoka, Japan
| | - Mika Kuroiwa
- Clinical Research Center, National Hospital Organization Fukuoka Higashi Medical Center, Fukuoka, Japan
| | - Nobuyuki Sudo
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Ma Y, Jiang Q, Yang B, Hu X, Shen G, Shen W, Xu J. Platelet mitochondria, a potent immune mediator in neurological diseases. Front Physiol 2023; 14:1210509. [PMID: 37719457 PMCID: PMC10502307 DOI: 10.3389/fphys.2023.1210509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 08/17/2023] [Indexed: 09/19/2023] Open
Abstract
Dysfunction of the immune response is regarded as a prominent feature of neurological diseases, including neurodegenerative diseases, malignant tumors, acute neurotraumatic insult, and cerebral ischemic/hemorrhagic diseases. Platelets play a fundamental role in normal hemostasis and thrombosis. Beyond those normal functions, platelets are hyperactivated and contribute crucially to inflammation and immune responses in the central nervous system (CNS). Mitochondria are pivotal organelles in platelets and are responsible for generating most of the ATP that is used for platelet activation and aggregation (clumping). Notably, platelet mitochondria show marked morphological and functional alterations under heightened inflammatory/oxidative stimulation. Mitochondrial dysfunction not only leads to platelet damage and apoptosis but also further aggravates immune responses. Improving mitochondrial function is hopefully an effective strategy for treating neurological diseases. In this review, the authors discuss the immunomodulatory roles of platelet-derived mitochondria (PLT-mitos) in neurological diseases and summarize the neuroprotective effects of platelet mitochondria transplantation.
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Affiliation(s)
- Yan Ma
- Transfusion Research Department, Wuhan Blood Center, Wuhan, Hubei, China
- Institute of Blood Transfusion of Hubei Province, Wuhan Blood Center, Wuhan, Hubei, China
- Wuhan National Laboratory for Optoelectronics and School of Physics, Huazhong University of Science and Technology, Wuhan, China
| | - Qian Jiang
- Transfusion Research Department, Wuhan Blood Center, Wuhan, Hubei, China
- Institute of Blood Transfusion of Hubei Province, Wuhan Blood Center, Wuhan, Hubei, China
- Wuhan National Laboratory for Optoelectronics and School of Physics, Huazhong University of Science and Technology, Wuhan, China
| | - Bingxin Yang
- Wuhan Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiaoyu Hu
- Transfusion Research Department, Wuhan Blood Center, Wuhan, Hubei, China
- Institute of Blood Transfusion of Hubei Province, Wuhan Blood Center, Wuhan, Hubei, China
- Wuhan National Laboratory for Optoelectronics and School of Physics, Huazhong University of Science and Technology, Wuhan, China
| | - Gang Shen
- Transfusion Research Department, Wuhan Blood Center, Wuhan, Hubei, China
- Institute of Blood Transfusion of Hubei Province, Wuhan Blood Center, Wuhan, Hubei, China
| | - Wei Shen
- Wuhan Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jing Xu
- Wuhan Blood Center, Wuhan, Hubei, China
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Simonetti A, Pais C, Savoia V, Cipriani MC, Tosato M, Janiri D, Bernardi E, Ferrara OM, Margoni S, Kotzalidis GD, Chieffo D, Fantoni M, Liperoti R, Landi F, Bernabei R, Sani G. Association of Delirium and Depression with Respiratory and Outcome Measures in COVID-19 Inpatients. J Pers Med 2023; 13:1207. [PMID: 37623458 PMCID: PMC10456095 DOI: 10.3390/jpm13081207] [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: 04/07/2023] [Revised: 07/18/2023] [Accepted: 07/27/2023] [Indexed: 08/26/2023] Open
Abstract
Delirium (DEL) and depression (DEP) may impair the course and severity of acute respiratory illness. The impact of such syndromes on respiratory and outcome parameters in inpatients with COVID-19 needs clarification. To clarify the relationship between DEL and DEP and respiratory outcome measures, we enrolled 100 inpatients from COVID-19 units of the Fondazione Policlinico Universitario Agostino Gemelli IRCCS of Rome. Participants were divided into those with DEL, DEP, or absence of either delirium or depression (CONT). Delirium severity was assessed with the Neelson and Champagne Confusion Scale (NEECHAM). Psychopathology was assessed with the Hamilton Rating Scale for Depression (HAM-D), the Hamilton Rating Scale for Anxiety (HAM-A), and the Brief Psychiatric Rating Scale (BPRS). Dependent variables include: (a) respiratory parameters, i.e., partial pressure of oxygen in arterial blood (PaO2), oxygen saturation (SpO2), ratio between arterial partial pressure of oxygen (PaO2), and fraction of inspired oxygen (PaO2/FiO2); (b) outcome parameters, i.e., duration of hospitalization and number of pharmacological treatments used during the hospitalization. We investigated between-group differences and the relationships between severity of delirium/depression and the dependent variables. Duration of hospitalization was longer for DEL than for either DEP or CONT and for DEP compared to CONT. NEECHAM and HAM-D scores predicted lower PaO2 and PaO2/FiO2 levels in the DEL and DEP groups, respectively. In DEP, BPRS scores positively correlated with duration of hospitalization. Delirium impacted the course of COVID-19 more severely than depression. The mechanisms by which delirium and depression worsen respiratory parameters differ.
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Affiliation(s)
- Alessio Simonetti
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX 77030, USA;
- Department of Neuroscience, Section of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (D.J.); (O.M.F.); (S.M.); (G.S.)
| | - Cristina Pais
- Department of Geriatrics, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy (M.C.C.); (M.T.); (R.L.); (F.L.); (R.B.)
| | - Vezio Savoia
- Service of Clinical Psychology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (V.S.); (D.C.)
| | - Maria Camilla Cipriani
- Department of Geriatrics, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy (M.C.C.); (M.T.); (R.L.); (F.L.); (R.B.)
| | - Matteo Tosato
- Department of Geriatrics, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy (M.C.C.); (M.T.); (R.L.); (F.L.); (R.B.)
| | - Delfina Janiri
- Department of Neuroscience, Section of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (D.J.); (O.M.F.); (S.M.); (G.S.)
- Department of Neurology and Psychiatry, Sapienza University of Rome, 00185 Rome, Italy
| | - Evelina Bernardi
- Department of Neuroscience, Section of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (D.J.); (O.M.F.); (S.M.); (G.S.)
| | - Ottavia Marianna Ferrara
- Department of Neuroscience, Section of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (D.J.); (O.M.F.); (S.M.); (G.S.)
| | - Stella Margoni
- Department of Neuroscience, Section of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (D.J.); (O.M.F.); (S.M.); (G.S.)
| | - Georgios D. Kotzalidis
- Department of Neuroscience, Section of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (D.J.); (O.M.F.); (S.M.); (G.S.)
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sant’Andrea Hospital, Sapienza–Università di Roma, 00189 Rome, Italy
| | - Daniela Chieffo
- Service of Clinical Psychology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (V.S.); (D.C.)
- Department of Life Sciences and Public Health, Faculty of Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Massimo Fantoni
- Laboratory and Infectious Diseases Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo F. Vito 1, 00168 Rome, Italy;
- Infectious Diseases Section, Department of Safety and Bioethics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Rosa Liperoti
- Department of Geriatrics, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy (M.C.C.); (M.T.); (R.L.); (F.L.); (R.B.)
- Department of Geriatrics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Francesco Landi
- Department of Geriatrics, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy (M.C.C.); (M.T.); (R.L.); (F.L.); (R.B.)
- Department of Geriatrics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Roberto Bernabei
- Department of Geriatrics, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy (M.C.C.); (M.T.); (R.L.); (F.L.); (R.B.)
- Department of Geriatrics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Gabriele Sani
- Department of Neuroscience, Section of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (D.J.); (O.M.F.); (S.M.); (G.S.)
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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Stefano GB, Büttiker P, Weissenberger S, Ptacek R, Wang F, Esch T, Bilfinger TV, Raboch J, Kream RM. Biomedical Perspectives of Acute and Chronic Neurological and Neuropsychiatric Sequelae of COVID-19. Curr Neuropharmacol 2022; 20:1229-1240. [PMID: 34951387 PMCID: PMC9886822 DOI: 10.2174/1570159x20666211223130228] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 12/10/2021] [Accepted: 12/17/2021] [Indexed: 11/22/2022] Open
Abstract
The incidence of infections from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the etiologic agent for coronavirus disease 2019 (COVID-19), has dramatically escalated following the initial outbreak in China, in late 2019, resulting in a global pandemic with millions of deaths. Although the majority of infected patients survive, and the rapid advent and deployment of vaccines have afforded increased immunity against SARS-CoV-2, long-term sequelae of SARS-CoV-2 infection have become increasingly recognized. These include, but are not limited to, chronic pulmonary disease, cardiovascular disorders, and proinflammatory-associated neurological dysfunction that may lead to psychological and neurocognitive impairment. A major component of cognitive dysfunction is operationally categorized as "brain fog" which comprises difficulty concentrating, forgetfulness, confusion, depression, and fatigue. Multiple parameters associated with long-term neuropsychiatric sequelae of SARS-CoV-2 infection have been detailed in clinical studies. Empirically elucidated mechanisms associated with the neuropsychiatric manifestations of COVID-19 are by nature complex, but broad-based working models have focused on mitochondrial dysregulation, leading to systemic reductions of metabolic activity and cellular bioenergetics within the CNS structures. Multiple factors underlying the expression of brain fog may facilitate future pathogenic insults, leading to repetitive cycles of viral and bacterial propagation. Interestingly, diverse neurocognitive sequelae associated with COVID-19 are not dissimilar from those observed in other historical pandemics, thereby providing a broad and integrative perspective on potential common mechanisms of CNS dysfunction subsequent to viral infection. Poor mental health status may be reciprocally linked to compromised immune processes and enhanced susceptibility to infection by diverse pathogens. By extrapolation, we contend that COVID-19 may potentiate the severity of neurological/neurocognitive deficits in patients afflicted by well-studied neurodegenerative disorders, such as Alzheimer's disease and Parkinson's disease. Accordingly, the prevention, diagnosis, and management of sustained neuropsychiatric manifestations of COVID-19 are pivotal health care directives and provide a compelling rationale for careful monitoring of infected patients, as early mitigation efforts may reduce short- and long-term complications.
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Affiliation(s)
- George B. Stefano
- Center for Cognitive and Molecular Neuroscience, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Pascal Büttiker
- Center for Cognitive and Molecular Neuroscience, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Simon Weissenberger
- Center for Cognitive and Molecular Neuroscience, First Faculty of Medicine, Charles University, Prague, Czech Republic
- Department of Psychology, University of New York in Prague, Prague, Czech Republic
| | - Radek Ptacek
- Center for Cognitive and Molecular Neuroscience, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Fuzhou Wang
- Group of Neuropharmacology and Neurophysiology, Division of Neuroscience, The Bonoi Academy of Science and Education, Chapel Hill, NC27510, USA
| | - Tobias Esch
- Institute for Integrative Health Care and Health Promotion, Faculty of Health/School of Medicine, Witten/Herdecke University, Witten, Germany
| | - Thomas V. Bilfinger
- Department of Surgery, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY11794, USA
| | - Jiri Raboch
- Center for Cognitive and Molecular Neuroscience, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Richard M. Kream
- Center for Cognitive and Molecular Neuroscience, First Faculty of Medicine, Charles University, Prague, Czech Republic
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Osca-Verdegal R, Beltrán-García J, Pallardó FV, García-Giménez JL. Role of microRNAs As Biomarkers in Sepsis-Associated Encephalopathy. Mol Neurobiol 2021; 58:4682-4693. [PMID: 34160774 PMCID: PMC8220114 DOI: 10.1007/s12035-021-02445-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 06/06/2021] [Indexed: 12/29/2022]
Abstract
Sepsis-associated encephalopathy (SAE) is a neurological complication of sepsis, characterized by brain dysfunction without any direct central nervous system infection. The diagnosis of SAE is currently a challenge. In fact, problems in making a diagnosis of SAE cause a great variability of incidence that can reach up to 70% of all septic patients. Even more, despite SAE is the most frequent type of encephalopathy occurring in critically ill patients, the molecular mechanisms that guide its progression have not been completely elucidated. On the other hand, miRNAs have proven to be excellent biomarkers for both diagnosis and prognosis, especially in brain pathologies because of their small size they can cross the blood–brain barrier easier than other biomolecules. The identification of new miRNAs as biomarkers may help to improve SAE diagnosis and prognosis and also to design new therapies for this clinical manifestation that produces diffuse cerebral dysfunction. This review is focused on SAE physiopathology and the need to have clear criteria for its diagnosis; thus, this work postulates some miRNA candidates to be used for SAE biomarkers because of their role in both, neurological damage and sepsis.
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Affiliation(s)
- Rebeca Osca-Verdegal
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Valencia, Spain
- Departamento de Fisiología, Facultad de Medicina Y Odontología, Universitat de València, València, Spain
| | - Jesús Beltrán-García
- Departamento de Fisiología, Facultad de Medicina Y Odontología, Universitat de València, València, Spain
- Instituto de Investigación Sanitaria INCLIVA, Valencia, Spain
| | - Federico V. Pallardó
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Valencia, Spain
- Departamento de Fisiología, Facultad de Medicina Y Odontología, Universitat de València, València, Spain
- Instituto de Investigación Sanitaria INCLIVA, Valencia, Spain
| | - José Luis García-Giménez
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Valencia, Spain
- Departamento de Fisiología, Facultad de Medicina Y Odontología, Universitat de València, València, Spain
- Instituto de Investigación Sanitaria INCLIVA, Valencia, Spain
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