ABSTRACT
BACKGROUND: The novel coronavirus (COVID-19) pandemic has affected humans worldwide and led to unprecedented stress and mortality. Detrimental effects of the pandemic on mental health, including risk of post-traumatic stress disorder (PTSD), have become an increasing concern. The identification of prospective neurobiological vulnerability markers for developing PTSD symptom during the pandemic is thus of high importance. METHODS: Before the COVID-19 outbreak (September 20, 2019-January 11, 2020), some healthy participants underwent resting-state functional connectivity MRI (rs-fcMRI) acquisition. We assessed the PTSD symptomology of these individuals during the peak of COVID-19 pandemic (February 21, 2020-February 28, 2020) in China. This pseudo-prospective cohort design allowed us to test whether the pre-pandemic neural connectome status could predict the risk of developing PTSD symptom during the pandemic. RESULTS: A total of 5.60% of participants (n = 42) were identified as being high-risk to develop PTSD symptom and 12.00% (n = 90) exhibited critical levels of PTSD symptoms during the COVID-19 pandemic. Pre-pandemic measures of functional connectivity (the neural connectome) prospectively classified those with heightened risk to develop PTSD symptom from matched controls (Accuracy = 76.19%, Sensitivity = 80.95%, Specificity = 71.43%). The trained classifier generalized to an independent sample. Continuous prediction models revealed that the same connectome could accurately predict the severity of PTSD symptoms within individuals (r 2 = 0.31p<.0). CONCLUSIONS: This study confirms COVID-19 break as a crucial stressor to bring risks developing PTSD symptom and demonstrates that brain functional markers can prospectively identify individuals at risk to develop PTSD symptom.