Are serum hsCRP and IL-6 prognostic markers in somatic symptom disorder and related disorders? An exploratory analysis in a prospective cohort study

Heseltine-Carp, William; Dale, Veronica; Sluijs, Jonna van Eck van der; Feltz-Cornelis, Christina M. van der

doi:10.1016/j.jpsychires.2022.11.026

Cited by 3 publications

(3 citation statements)

References 44 publications

(43 reference statements)

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“…There have been previous findings of systemic low-grade inflammation in psychiatric disorders in the literature, 9 which has various implications for treatment and clinical outcomes. 10,11 Furthermore, we have also corroborated the evidence from previous work 5 that female patients are significantly more likely to report neuropsychiatric symptoms in the post-COVID-19 period, as in this study anxiety and myalgia were significantly more common in females.…”

Section: Discussionsupporting

confidence: 90%

Examining the relationship between inflammatory biomarkers during COVID‐19 hospitalization and subsequent long‐COVID symptoms: A longitudinal and retrospective study

Sykes,

Van der Feltz‐Cornelis,

Holdsworth

et al. 2023

Immunity Inflam & Disease

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IntroductionLong‐COVID is a heterogeneous condition with a litany of physical and neuropsychiatric presentations and its pathophysiology remains unclear. Little is known about the association between inflammatory biomarkers, such as interleukin‐6 (IL‐6) and C‐reactive protein (CRP) in the acute phase, and persistent symptoms after hospitalization in COVID‐19 patients.MethodsIL‐6, CRP, troponin‐T, and ferritin were analyzed at admission for all patients with COVID‐19 between September 1, 2020 to January 10, 2021. Survivors were followed up 3‐months following hospital discharge and were asked to report persistent symptoms they experienced. Admission data were retrospectively collected. Independent t‐tests and Mann–Whitney U tests were performed.ResultsIn a sample of 144 patients (62.5% male, mean Age 62 years [SD = 13.6]) followed up 3 months after hospital discharge, the commonest symptoms reported were fatigue (54.2%), breathlessness (52.8%), and sleep disturbance (37.5%). In this sample, admission levels of IL‐6, CRP and ferritin were elevated. However, those reporting myalgia, low mood, and anxiety at follow‐up had lower admission levels of IL‐6 (34.9 vs. 52.0 pg/mL, p = .043), CRP (83 vs. 105 mg/L, p = .048), and ferritin (357 vs. 568 ug/L, p = .01) respectively, compared with those who did not report these symptoms. Multivariate regression analysis showed that these associations were confounded by gender, as female patients had significantly lower levels of IL‐6 and ferritin on admission (29.5 vs. 56.1, p = .03 and 421.5 vs. 589, p = .001, respectively) and were more likely to report myalgia, low mood and anxiety, when compared to males.ConclusionsOur data demonstrate that female patients present more often with lower levels of inflammatory biomarkers on admission which are subsequently associated with long‐term post‐COVID symptoms, such as myalgia and anxiety, in those discharged from hospital with severe COVID‐19. Further research is needed into the role of serum biomarkers in post‐COVID prognostication.

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Section: Discussionsupporting

confidence: 90%

Examining the relationship between inflammatory biomarkers during COVID‐19 hospitalization and subsequent long‐COVID symptoms: A longitudinal and retrospective study

Sykes,

Van der Feltz‐Cornelis,

Holdsworth

et al. 2023

Immunity Inflam & Disease

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“…(20)(21)(22)(23) And this has implications for treatment and treatment outcomes in a variety of mental disorders . (24,25) Persistent neuropsychiatric symptoms are commonly reported in those with Long-COVID. Meta-analysis data show the commonest symptoms to be sleep disturbance, anxiety, objective cognitive impairments, and fatigue.…”

Section: Discussionmentioning

confidence: 99%

Inflammatory Biomarkers as Predictors of Mortality and Persistent Symptoms at Follow-up in Patients with Severe COVID-19

Sykes

Feltz-Cornelis

Holdsworth

et al. 2022

Preprint

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Background Serum inflammatory biomarkers such as C-reactive protein (CRP) are an established tool for predicting mortality in COVID-19 patients. Data have also suggested that such biomarkers are persistently elevated in patients with Long-COVID. In this study we aimed to assess the relationship between a panel of serum biomarkers (CRP, IL-6, troponin-T, and ferritin), inpatient mortality, and persistent symptoms post-discharge in COVID-19 survivors. Methods Data were collected retrospectively for all patients with COVID-19 admitted between 1st September 2020 and 10th January 2021. Admission CRP, IL-6, ferritin, and troponin-T were collected alongside routinely collected clinical data. A standardised dataset was collected for survivors when they attended clinical follow-up with the local post-hospitalisation COVID-19 follow-up service. Results A total of 626 patients (mean age 70.1 [SD=15.8], 55% male) had all biomarkers recorded. The overall mortality rate in this cohort was 28.4%. Higher levels of IL-6 (p<0.001) and troponin-T (p<0.001) were associated with a significantly higher risk of inpatient mortality. A total of 144 patients received 3-month follow-up, the commonest reported symptoms were fatigue (54.2%), breathlessness (52.8%), and sleep disturbance (37.5%). Patients who reported myalgia, low mood, and anxiety were found to have lower median levels of IL-6, CRP, and ferritin, respectively. Conclusions Raised levels of IL-6 and TT on admission are associated with a significantly increased risk of inpatient mortality in those hospitalised with COVID-19, however, raised inflammatory markers at the time of hospital admission show no association with residual symptom burden at 3-month follow-up in surviving patients.

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“…CRP can be elevated in some other chronic conditions, such as emphysema and chronic bronchitis, showing a persistent inflammatory response, while another study showed that CRP levels were not significantly higher in mild/moderate emphysema cases compared to those without emphysema, yet CRP titers were modestly correlated with FEV(1)% in people with airflow obstruction [ 307 , 308 ]. A study concluded that elevated CRP levels are highly and independently linked to respiratory impairment and more frequent Bronchial Hyperresponsiveness (BHR), and these results indicate that both respiratory impairment and BHR are related to a systemic inflammatory process [ 309 ].…”

Section: Current Evidence On C-reactive Protein and Potential Conditionsmentioning

confidence: 99%

C-Reactive Protein: Pathophysiology, Diagnosis, False Test Results and a Novel Diagnostic Algorithm for Clinicians

Mouliou

2023

Diseases

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The current literature provides a body of evidence on C-Reactive Protein (CRP) and its potential role in inflammation. However, most pieces of evidence are sparse and controversial. This critical state-of-the-art monography provides all the crucial data on the potential biochemical properties of the protein, along with further evidence on its potential pathobiology, both for its pentameric and monomeric forms, including information for its ligands as well as the possible function of autoantibodies against the protein. Furthermore, the current evidence on its potential utility as a biomarker of various diseases is presented, of all cardiovascular, respiratory, hepatobiliary, gastrointestinal, pancreatic, renal, gynecological, andrological, dental, oral, otorhinolaryngological, ophthalmological, dermatological, musculoskeletal, neurological, mental, splenic, thyroid conditions, as well as infections, autoimmune-supposed conditions and neoplasms, including other possible factors that have been linked with elevated concentrations of that protein. Moreover, data on molecular diagnostics on CRP are discussed, and possible etiologies of false test results are highlighted. Additionally, this review evaluates all current pieces of evidence on CRP and systemic inflammation, and highlights future goals. Finally, a novel diagnostic algorithm to carefully assess the CRP level for a precise diagnosis of a medical condition is illustrated.

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Are serum hsCRP and IL-6 prognostic markers in somatic symptom disorder and related disorders? An exploratory analysis in a prospective cohort study

Cited by 3 publications

References 44 publications

Examining the relationship between inflammatory biomarkers during COVID‐19 hospitalization and subsequent long‐COVID symptoms: A longitudinal and retrospective study

Examining the relationship between inflammatory biomarkers during COVID‐19 hospitalization and subsequent long‐COVID symptoms: A longitudinal and retrospective study

Inflammatory Biomarkers as Predictors of Mortality and Persistent Symptoms at Follow-up in Patients with Severe COVID-19

C-Reactive Protein: Pathophysiology, Diagnosis, False Test Results and a Novel Diagnostic Algorithm for Clinicians

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