Alteration of Inflammatory Parameters and Psychological Post-Traumatic Syndrome in Long-COVID Patients

Abstract

The aim of our study is to evaluate the correlation between the psychological status of patients recovered from SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) infection (long-COVID patients) and their inflammatory status. Three months after hospital discharge, ninety-three patients were recruited and categorized into two distinct populations: control and long-COVID (COrona VIrus Disease) group. Patients belonging to the control group presented with an entering diagnosis of cardiovascular, metabolic, or respiratory disease and a negative history of SARS-CoV-2 infection, whereas the long-COVID population presented with a severe SARS-CoV-2 infection treated in the sub-intensive Care Unit. Psychological evaluation was performed through the administration of the Symptom Checklist-90 (SCL90) and LDH (Lactate dehydrogenase), ferritin, CRPhs (C-high sensitivity Reactive Protein), NLR (Neutrophil-to-lymphocyte ratio), PLR (Platelet-to-lymphocyte ratio), and SII (systemic immune-inflammation index) were investigated. We highlighted that beyond the first three months after contagion, patients recovered from SARS-CoV-2 infection are characterized by the persistence of a systemic inflammatory state and are at high risk for developing somatization, depression, anxiety, and sleep disturbances. Interestingly, ferritin value was strongly correlated with sleep disorders (p < 0.05). Our study emphasizes how COVID-19 strategies for risk stratification, prognosis, and therapy management of patients should be implemented with a psychological follow-up.

Psychological and Cognitive Effects of Long COVID: A Narrative Review Focusing on the Assessment and Rehabilitative Approach

“…Indeed, the incidence of anxiety, depression, and post-traumatic stress was 42%, 31%, and 28%, respectively, in an Italian sample [ 60 ]. Considering the alarming impact of COVID-19 on mental health, Clemente et al investigated the correlation between the psychological status of patients who had recovered from the SARS-CoV-2 infection and their inflammatory status, showing that survivors are at risk of developing psychiatric sequelae, such as anxiety, depression, and somatization symptoms, as well as sleep disorders [ 61 , 62 , 63 ]. An interesting association has also been demonstrated between high ferritin blood levels and sleep disturbances, stress, depression, and suicidal ideation [ 64 , 65 ].…”

Lactate dehydrogenase contribution to symptom persistence in long COVID: A pooled analysis

“…Finally, 46 studies with 8289 participants (3338 PASC and 4951 controls) were included in our pooled analysis (Table 1). 24–69 These included studies were all peer‐reviewed, published between 2020 and 2023; had data from 28 studies in Resp‐PASC, 10 studies in Neuro‐PASC, 5 studies in Cardio‐PASC, 2 studies in gastrointestinal‐PASC and as only 1 study was in Reno‐PASC. Thirty‐four studies were of cohort design, 11 were case control and 1 cross‐sectional.…”

Characteristics of Sleep Disturbance in Patients with Long COVID: A Retrospective Observational Study in Japan

“…Such a clinical condition complicated with sleep disorders and brain fog may arise from a combined mechanism of biological and psychological damages [19]. A persistent systemic inflammatory state [30], in addition to social isolation and trauma during acute infection and chronic fatigue [31], might be complexly and individually involved in the neuropsychiatric symptoms, especially in patients with sleep disturbances.…”