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1.
Brain Behav Immun ; 87: 8-9, 2020 07.
Article in English | MEDLINE | ID: covidwho-1719343

ABSTRACT

The COVID-19 pandemic has led to high levels of psychological distress in the general public, including symptoms of anxiety and depression. Such distress is associated with alterations in immune function, including an elevated risk of viral respiratory tract infections. In this light, the possible effects of Ayurveda, a traditional system of medicine promoted by the Indian government as an "immune booster", are examined from the point of view of psychoneuroimmune mechanisms as well as the "meaning response" described by Moerman. It was found that many of the measures advocated in their guidelines could positively influence immunity either by direct effects on symptoms of depression or anxiety, or through their symbolic significance. Therefore, it is possible that such traditional practices could be beneficial both in terms of psychological quality of life, and in terms of moderating the risk of infection.


Subject(s)
Anxiety/immunology , Coronavirus Infections/epidemiology , Depression/immunology , Medicine, Ayurvedic , Pneumonia, Viral/epidemiology , Psychoneuroimmunology , Stress, Psychological/immunology , Anxiety/epidemiology , Anxiety/psychology , Betacoronavirus , COVID-19 , Coriandrum , Cuminum , Curcuma , Depression/epidemiology , Depression/psychology , Garlic , Guidelines as Topic , Humans , India/epidemiology , Pandemics , Plant Preparations , Psychological Distress , SARS-CoV-2 , Spices , Stress, Psychological/epidemiology , Stress, Psychological/psychology , Teas, Herbal , Yoga
2.
Brain Behav Immun ; 87: 34-39, 2020 07.
Article in English | MEDLINE | ID: covidwho-1719335

ABSTRACT

The coronavirus disease 19 (COVID-19) pandemic is a significant psychological stressor in addition to its tremendous impact on every facet of individuals' lives and organizations in virtually all social and economic sectors worldwide. Fear of illness and uncertainty about the future precipitate anxiety- and stress-related disorders, and several groups have rightfully called for the creation and dissemination of robust mental health screening and treatment programs for the general public and front-line healthcare workers. However, in addition to pandemic-associated psychological distress, the direct effects of the virus itself (several acute respiratory syndrome coronavirus; SARS-CoV-2), and the subsequent host immunologic response, on the human central nervous system (CNS) and related outcomes are unknown. We discuss currently available evidence of COVID-19 related neuropsychiatric sequelae while drawing parallels to past viral pandemic-related outcomes. Past pandemics have demonstrated that diverse types of neuropsychiatric symptoms, such as encephalopathy, mood changes, psychosis, neuromuscular dysfunction, or demyelinating processes, may accompany acute viral infection, or may follow infection by weeks, months, or longer in recovered patients. The potential mechanisms are also discussed, including viral and immunological underpinnings. Therefore, prospective neuropsychiatric monitoring of individuals exposed to SARS-CoV-2 at various points in the life course, as well as their neuroimmune status, are needed to fully understand the long-term impact of COVID-19, and to establish a framework for integrating psychoneuroimmunology into epidemiologic studies of pandemics.


Subject(s)
Coronavirus Infections/psychology , Cytokine Release Syndrome/psychology , Mental Disorders/psychology , Nervous System Diseases/psychology , Pneumonia, Viral/psychology , Acute Disease , Anxiety/etiology , Anxiety/immunology , Anxiety/psychology , Bacterial Translocation , Betacoronavirus , COVID-19 , Chronic Disease , Coronavirus Infections/complications , Coronavirus Infections/immunology , Coronavirus Infections/therapy , Cytokine Release Syndrome/immunology , Cytokine Release Syndrome/therapy , Demyelinating Diseases/etiology , Demyelinating Diseases/immunology , Demyelinating Diseases/physiopathology , Demyelinating Diseases/psychology , Depression/etiology , Depression/immunology , Depression/psychology , Humans , Immunologic Factors/adverse effects , Mental Disorders/etiology , Mental Disorders/immunology , Mental Health , Nervous System Diseases/etiology , Nervous System Diseases/immunology , Nervous System Diseases/physiopathology , Neurodegenerative Diseases/etiology , Neurodegenerative Diseases/immunology , Neurodegenerative Diseases/physiopathology , Neurodegenerative Diseases/psychology , Pandemics , Pneumonia, Viral/complications , Pneumonia, Viral/immunology , Pneumonia, Viral/therapy , Psychoneuroimmunology , Psychotic Disorders/etiology , Psychotic Disorders/immunology , Psychotic Disorders/psychology , Public Health , SARS-CoV-2 , Stress Disorders, Post-Traumatic/etiology , Stress Disorders, Post-Traumatic/immunology , Stress Disorders, Post-Traumatic/psychology
3.
Med Clin (Barc) ; 156(7): 332-335, 2021 04 09.
Article in English, Spanish | MEDLINE | ID: covidwho-957301

ABSTRACT

INTRODUCTION: Rise of central cytokines resulting from infections produces neuronal changes. Covid-19 allows the study of depressive symptoms in sustained stress and its relationship with molecular mechanisms. OBJECTIVES: To assess correlation between IL-6, IL-1ß and TNF-α and depressive symptoms. Characterize the depressive symptoms present. METHODS: Observational study. Patients admitted for Covid-19 older than 60 years with a interleukin determination were included. The Yesavage Geriatric Depression Scale (GDS) was used, associating each item with a neurotransmitter. RESULTS: 27 patients included. We did not find correlation between IL-6 levels and the GDS scale score (rho=0.204; 95% CI -0.192 to 0.543); with IL-1ß levels (rho=-0.126; 95% CI -0.490 to 0.276); nor of TNF-α (rho=-0.033; 95% CI -0.416 to 0.360). 3 patients (11.1%) presented score compatible with depressive disorder. It was associated with a deficiency of noradrenaline and serotonin. CONCLUSIONS: We found no correlation between the levels of IL-6, IL-1ß, and TNF-α with the GDS score. Depressive symptomatology is similar to vascular depressions.


Subject(s)
COVID-19/psychology , Depression/immunology , Depression/virology , Interleukin-1beta/blood , Interleukin-6/blood , Tumor Necrosis Factor-alpha/blood , Aged , Aged, 80 and over , Biomarkers/blood , COVID-19/blood , COVID-19/immunology , Depression/blood , Depression/diagnosis , Female , Humans , Male , Middle Aged , Psychiatric Status Rating Scales , Risk Factors
5.
Prostaglandins Leukot Essent Fatty Acids ; 161: 102177, 2020 10.
Article in English | MEDLINE | ID: covidwho-796199

ABSTRACT

As the infected cases of COVID-19 reach more than 20 million with more than 778,000 deaths globally, an increase in psychiatric disorders including anxiety and depression has been reported. Scientists globally have been searching for novel therapies and vaccines to fight against COVID-19. Improving innate immunity has been suggested to block progression of COVID-19 at early stages, while omega-3 polyunsaturated fatty acids (n-3 PUFAs) have been shown to have immunomodulation effects. Moreover, n-3 PUFAs have also been shown to improve mood disorders, thus, future research is warranted to test if n-3 PUFAs may have the potential to improve our immunity to counteract both physical and mental impact of COVID-19.


Subject(s)
Anxiety/prevention & control , Coronavirus Infections/prevention & control , Depression/prevention & control , Dietary Supplements , Fatty Acids, Omega-3/administration & dosage , Immunologic Factors/administration & dosage , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Anxiety/immunology , Anxiety/metabolism , Anxiety/virology , Betacoronavirus/immunology , Betacoronavirus/pathogenicity , COVID-19 , Coronavirus Infections/immunology , Coronavirus Infections/metabolism , Coronavirus Infections/virology , Cytokines/biosynthesis , Cytokines/immunology , Dendritic Cells/drug effects , Dendritic Cells/immunology , Dendritic Cells/virology , Depression/immunology , Depression/metabolism , Depression/virology , Epithelial Cells/drug effects , Epithelial Cells/immunology , Epithelial Cells/virology , Fatty Acids, Omega-3/immunology , Fatty Acids, Omega-3/metabolism , Host-Pathogen Interactions/drug effects , Host-Pathogen Interactions/immunology , Humans , Immunity, Innate/drug effects , Immunologic Factors/immunology , Immunologic Factors/metabolism , Lymphocytes/drug effects , Lymphocytes/immunology , Lymphocytes/virology , Macrophages/drug effects , Macrophages/immunology , Macrophages/virology , Pneumonia, Viral/immunology , Pneumonia, Viral/metabolism , Pneumonia, Viral/virology , SARS-CoV-2
8.
Brain Behav Immun ; 89: 594-600, 2020 10.
Article in English | MEDLINE | ID: covidwho-688835

ABSTRACT

Infection-triggered perturbation of the immune system could induce psychopathology, and psychiatric sequelae were observed after previous coronavirus outbreaks. The spreading of the Severe Acute Respiratory Syndrome Coronavirus (COVID-19) pandemic could be associated with psychiatric implications. We investigated the psychopathological impact of COVID-19 in survivors, also considering the effect of clinical and inflammatory predictors. We screened for psychiatric symptoms 402 adults surviving COVID-19 (265 male, mean age 58), at one month follow-up after hospital treatment. A clinical interview and a battery of self-report questionnaires were used to investigate post-traumatic stress disorder (PTSD), depression, anxiety, insomnia, and obsessive-compulsive (OC) symptomatology. We collected sociodemographic information, clinical data, baseline inflammatory markers and follow-up oxygen saturation levels. A significant proportion of patients self-rated in the psychopathological range: 28% for PTSD, 31% for depression, 42% for anxiety, 20% for OC symptoms, and 40% for insomnia. Overall, 56% scored in the pathological range in at least one clinical dimension. Despite significantly lower levels of baseline inflammatory markers, females suffered more for both anxiety and depression. Patients with a positive previous psychiatric diagnosis showed increased scores on most psychopathological measures, with similar baseline inflammation. Baseline systemic immune-inflammation index (SII), which reflects the immune response and systemic inflammation based on peripheral lymphocyte, neutrophil, and platelet counts, positively associated with scores of depression and anxiety at follow-up. PTSD, major depression, and anxiety, are all high-burden non-communicable conditions associated with years of life lived with disability. Considering the alarming impact of COVID-19 infection on mental health, the current insights on inflammation in psychiatry, and the present observation of worse inflammation leading to worse depression, we recommend to assess psychopathology of COVID-19 survivors and to deepen research on inflammatory biomarkers, in order to diagnose and treat emergent psychiatric conditions.


Subject(s)
Anxiety Disorders/epidemiology , Coronavirus Infections/epidemiology , Depressive Disorder, Major/epidemiology , Pneumonia, Viral/epidemiology , Survivors/statistics & numerical data , Adolescent , Adult , Aged , Aged, 80 and over , Anxiety/epidemiology , Anxiety/immunology , Anxiety/psychology , Anxiety Disorders/immunology , Anxiety Disorders/psychology , Betacoronavirus , C-Reactive Protein/immunology , COVID-19 , Coronavirus Infections/immunology , Coronavirus Infections/psychology , Depression/epidemiology , Depression/immunology , Depression/psychology , Depressive Disorder/epidemiology , Depressive Disorder/immunology , Depressive Disorder/psychology , Depressive Disorder, Major/immunology , Depressive Disorder, Major/psychology , Emergency Service, Hospital , Female , Humans , Inflammation , Italy/epidemiology , Length of Stay/statistics & numerical data , Leukocyte Count , Lymphocyte Count , Male , Mental Disorders/epidemiology , Mental Disorders/immunology , Mental Disorders/psychology , Middle Aged , Monocytes , Neutrophils , Obsessive-Compulsive Disorder/epidemiology , Obsessive-Compulsive Disorder/immunology , Obsessive-Compulsive Disorder/psychology , Pandemics , Pneumonia, Viral/immunology , Pneumonia, Viral/psychology , SARS-CoV-2 , Severity of Illness Index , Sex Factors , Sleep Initiation and Maintenance Disorders/epidemiology , Sleep Initiation and Maintenance Disorders/immunology , Sleep Initiation and Maintenance Disorders/psychology , Stress Disorders, Post-Traumatic/epidemiology
9.
Brain Behav Immun ; 89: 587-593, 2020 10.
Article in English | MEDLINE | ID: covidwho-652159

ABSTRACT

OBJECTIVE: To evaluate the mental health status of hospitalized patients with coronavirus disease 2019 (COVID-19) and to explore the related factors. METHOD: This was a cross-sectional survey among COVID-19 inpatients in two isolation wards of a designated hospital in Wuhan, China, from March 7, 2020, to March 24, 2020. Participants' demographic data, clinical data and levels of circulating inflammatory markers were collated. Mental health symptoms were evaluated with questionnaires, which included the Insomnia Severity Index (ISI) scale, the 9-item Patient Health Questionnaire (PHQ-9), the 7-item Generalized Anxiety Disorder (GAD-7) scale, and questions about patients' self-perceived illness severity. Multivariate linear regression analysis was performed to explore factors that associated with mental symptoms, and a structural equation model (SEM) was used to assess the possible relationships between those factors and the patients' mental health. RESULTS: Among the 85 participants, 45.9% had symptoms of depression (PHQ-9 ≥ 5), 38.8% had anxiety (GAD-7 ≥ 5), and 54.1% had insomnia (ISI ≥ 8). According to multivariate regression analysis, female sex, a higher level of interleukin (IL)-1ß and greater self-perceived illness severity were all significantly associated with a higher PHQ-9 score, higher GAD-7 score and higher ISI score. In addition, the disease duration and the neutrophil to lymphocyte ratio (NLR) were positively related to patients' self-perceived illness severity. The results of the SEM analyses suggested that sex (ß = 0.313, P < 0.001), self-perceived illness severity (ß = 0.411, P < 0.001) and levels of inflammatory markers (ß = 0.358, P = 0.002) had direct effects on patients' mental health. The disease duration (ß = 0.163, P = 0.003) and levels of inflammatory markers (ß = 0.101, P = 0.016) also indirectly affected patients' mental health, with self-perceived illness severity acting as a mediator. CONCLUSION: A majority of COVID-19 infected inpatients reported experiencing mental health disturbances. Female sex, disease duration, levels of inflammatory markers and self-perceived illness severity are factors that could be used to predict the severity of patients' mental symptoms.


Subject(s)
Anxiety/psychology , Coronavirus Infections/psychology , Depression/psychology , Hospitalization , Pneumonia, Viral/psychology , Sleep Initiation and Maintenance Disorders/psychology , Adult , Anxiety/epidemiology , Anxiety/immunology , Betacoronavirus , COVID-19 , China/epidemiology , Coronavirus Infections/epidemiology , Coronavirus Infections/immunology , Cross-Sectional Studies , Depression/epidemiology , Depression/immunology , Female , Humans , Inflammation , Leukocyte Count , Lymphocyte Count , Male , Mental Health , Middle Aged , Neutrophils , Pandemics , Patient Health Questionnaire , Pneumonia, Viral/epidemiology , Pneumonia, Viral/immunology , SARS-CoV-2 , Severity of Illness Index , Sex Factors , Sleep Initiation and Maintenance Disorders/epidemiology , Sleep Initiation and Maintenance Disorders/immunology , Time Factors
10.
Brain Behav Immun ; 88: 39-43, 2020 08.
Article in English | MEDLINE | ID: covidwho-361461

ABSTRACT

Self-reported depression has been observed in coronavirus disease-2019 (COVID-19) patients, infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), during discharge from the hospital. However, the cause of this self-reported depression during the convalescent period remains unclear. Here, we report the mental health status of 96 convalescent COVID-19 patients who were surveyed using an online questionnaire at the Shenzhen Samii Medical Center from March 2 to March 12, 2020 in Shenzhen, China. After obtaining their informed consent, we retrospectively analyzed the clinical characteristics of patients, including routine blood and biochemical data. The results suggested that patients with self-reported depression exhibited increased immune response, as indicated by increased white blood cell and neutrophil counts, as well as neutrophil-to-lymphocyte ratio. However, the mechanism linking self-reported depression to these cellular changes needs further study. In conclusion, self-reported depression occurred at an early stage in convalescent COVID-19 patients, and changes in immune function were apparent during short-term follow-up of these patients after discharge. Appropriate psychological interventions are necessary, and changes in immune function should be emphasized during long-term follow up of these patients.


Subject(s)
Convalescence/psychology , Coronavirus Infections/psychology , Depression/psychology , Depressive Disorder/psychology , Pneumonia, Viral/psychology , Adult , Basophils , Betacoronavirus , C-Reactive Protein/immunology , COVID-19 , China , Coronavirus Infections/immunology , Depression/immunology , Depressive Disorder/immunology , Eosinophils , Female , Humans , Interleukin-6/immunology , Length of Stay , Leukocyte Count , Lymphocyte Count , Male , Middle Aged , Monocytes , Neutrophils , Pandemics , Pneumonia, Viral/immunology , SARS-CoV-2 , Self Report , Severity of Illness Index , Young Adult
11.
Brain Behav Immun ; 88: 17-27, 2020 08.
Article in English | MEDLINE | ID: covidwho-270288

ABSTRACT

Since the end of 2019, Corona Virus Disease 2019 (COVID-19) has been the cause of a worldwide pandemic. The mental status of patients with COVID-19 who have been quarantined and the interactions between their psychological distress and physiological levels of inflammation have yet to be analyzed. Using a mixed-method triangulation design (QUAN + QUAL), this study investigated and compared the mental status and inflammatory markers of 103 patients who, while hospitalized with mild symptoms, tested positive with COVID-19 and 103 matched controls that were COVID-19 negative. The severity of depression, anxiety, and post-traumatic stress symptoms (PTSS) was measured via an on-line survey. Using a convenience sampling technique, qualitative data were collected until the point of data saturation. In addition, a semi-structured interview was conducted among five patients with COVID-19. Peripheral inflammatory markers were also collected in patients, both at baseline and within ± three days of completing the on-line survey. Results revealed that COVID-19 patients, when compared to non-COVID controls, manifested higher levels of depression (P < 0.001), anxiety (P < 0.001), and post-traumatic stress symptoms (P < 0.001). A gender effect was observed in the score of "Perceived Helplessness", the subscale of PSS-10, with female patients showing higher scores compared to male patients (Z = 2.56, P = 0.010), female (Z = 2.37, P = 0.018) and male controls (Z = 2.87, P = 0.004). Levels of CRP, a peripheral inflammatory indicator, correlated positively with the PHQ-9 total score (R = 0.37, P = 0.003, Spearman's correlation) of patients who presented symptoms of depression. Moreover, the change of CRP level from baseline inversely correlated with the PHQ-9 total score (R = -0.31, P = 0.002), indicative of improvement of depression symptoms. Qualitative analysis revealed similar results with respect to patient reports of negative feelings, including fear, guilt, and helplessness. Stigma and uncertainty of viral disease progression were two main concerns expressed by COVID-19 patients. Our results indicate that significant psychological distress was experienced by hospitalized COVID-19 patients and that levels of depressive features may be related to the inflammation markers in these patients. Thus, we recommend that necessary measures should be provided to address depression and other psychiatric symptoms for COVID-19 patients and attention should be paid to patient perceived stigma and coping strategies when delivering psychological interventions.


Subject(s)
Anxiety/psychology , C-Reactive Protein/immunology , Coronavirus Infections/psychology , Depression/psychology , Inflammation/immunology , Pneumonia, Viral/psychology , Psychological Distress , Quarantine/psychology , Stress, Psychological/psychology , Adult , Aged , Anxiety/immunology , Betacoronavirus , Blood Sedimentation , COVID-19 , Case-Control Studies , Coronavirus Infections/immunology , Cross-Sectional Studies , Depression/immunology , Female , Hospitalization , Humans , Leukocyte Count , Male , Middle Aged , Pandemics , Patient Health Questionnaire , Pneumonia, Viral/immunology , Procalcitonin/immunology , SARS-CoV-2 , Sex Factors , Stress Disorders, Post-Traumatic/immunology , Stress Disorders, Post-Traumatic/psychology , Stress, Psychological/immunology
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