Hyper/neuroinflammation in COVID-19 and suicide etiopathogenesis: Hypothesis for a nefarious collision?

Costanza, Alessandra; Amerio, Andrea; Aguglia, Andrea; Serafini, Gianluca; Amore, Mario; Hasler,; Ambrosetti, Julia; Bondolfi, Guido; Sampogna, Gaia; Berardelli,; Fiorillo, Andrea; Pompili, Maurizio; Nguyen, KD

doi:10.1016/j.neubiorev.2022.104606

Cited by 18 publications

(15 citation statements)

References 196 publications

(204 reference statements)

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“…Evidence from rodents and humans supports that depressive-like behaviors are associated with neuroinflammatory priming ( Fenn et al, 2014 , Fonken et al, 2018 ). Emerging evidence also indicates a role of neuroinflammation underlying COVID-19 neuropathology ( Costanza et al, 2022 , Matschke et al, 2020 , Mingoti et al, 2022 , Ribeiro et al, 2021 ). Our results revealed that MyD88, a pivotal adaptor that forms innate immune signaling complex called the ‘myddosome’, controls stress susceptibility via amplifying proinflammatory signaling.…”

Section: Discussionmentioning

confidence: 99%

Adaptor protein MyD88 confers the susceptibility to stress via amplifying immune danger signals

Yao¹,

Ye²,

Tian³

et al. 2023

Brain, Behavior, and Immunity

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Section: Discussionmentioning

confidence: 99%

Adaptor protein MyD88 confers the susceptibility to stress via amplifying immune danger signals

Yao¹,

Ye²,

Tian³

et al. 2023

Brain, Behavior, and Immunity

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“…[11] To dive further into the role of SARS-CoV2 in the etiology of suicide risk, future studies should maybe assess suicide risk with respect to the biological consequences of the infection, such as the presence of inflammation processes, rather than only the presence of the virus. [5]…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] Regarding potential biological pathways, the exact role of SARS-CoV2 with regard to mechanisms involved in suicide risk has yet to be demonstrated. Nonetheless, the virus's ability to invade the central nervous system through fixation on angiotensin converting enzyme 2 receptors, [4] or to inflict brain damage through hyperinflammation, [5] are potential candidates. From a public health point of view, suicide risk related to COVID-19 disease was first supported by findings from cross-sectional studies and case series, [6,7] and limited evidence from longitudinal studies is now emerging.…”

Section: Introductionmentioning

confidence: 99%

COVID-19 illness, SARS-CoV2 infection, and subsequent suicidal ideation in the French nationwide population-based EpiCov cohort : a propensity score analysis of more than 50,000 individuals

Davisse‐Paturet

Orri

Legleye

et al. 2022

Preprint

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Symptomatic COVID-19 appears to be associated with suicidal ideation but longitudinal evidence is still scarce. SARS-CoV2-induced neurological damages might underline this association, but findings are inconsistent. We therefore investigated the association between COVID-19 disease and subsequent suicidal ideation in the general population, using both self-reported symptoms and serology as well as inverse probability weighting to draw as near as possible to the direct association. Using data from the nationwide French EpiCov cohort, COVID-19 disease was assessed through 1) COVID-19 illness (self-reported symptoms of sudden loss of taste/smell or fever alongside cough, shortness of breath or chest oppression, between February and November 2020), and 2) SARS-CoV2 infection (Spike protein ELISA test screening in dried-blood-spot samples). Suicidal ideation was self-reported between December 2020 and July 2021. Inverse probability weighting with propensity scores was used as an adjustment strategy, leading to balanced sociodemographic and health-related factors between the exposed and non-exposed groups of both COVID-19 disease measures. Then, modified Poisson regression models were used to investigate the association of COVID-19 illness and SARS-CoV2 infection with subsequent suicidal ideation. Among 52,050 participants from the EpiCov cohort, 1.68% [1.54%-1.82%] reported suicidal ideation in the first half of 2021, 9.57% [9.24%-9.90%] had a SARS-CoV2 infection in 2020 and 13.23% [12.86%-13.61%] reported COVID-19 symptoms in 2020. COVID-19 illness in 2020 was associated with higher risks of subsequent suicidal ideation in the first half of 2021 (Relative Riskipw [CI95%]= 1.43 [1.20-1.69]) while SARS-CoV2 infection in 2020 was not (RRipw = 0.88 [0.69-1.12]). If COVID-19 illness was associated with subsequent suicidal ideation, the exact role of SARS-CoV2 infection with respect to suicide risk has yet to be clarified. Psychological support should be offered to persons recovering from symptomatic COVID-19 in order to minimize suicidal ideation risk. Moreover, if such psychological support is to be implemented, serology status alone does not seem a relevant criterion to define persons who suffered from COVID-19 to prioritize.

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“…Regarding potential biological pathways, the exact role of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) with regard to mechanisms involved in suicide risk has yet to be demonstrated. Nonetheless, the virus’s ability to invade the central nervous system through fixation on angiotensin-converting enzyme 2 receptors [ 5 ], or to inflict brain damage through hyperinflammation [ 6 ], are potential candidates.…”

Section: Introductionmentioning

confidence: 99%

Suicidal ideation following self-reported COVID-19-like symptoms or serology-confirmed SARS-CoV-2 infection in France: A propensity score weighted analysis from a cohort study

et al. 2023

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Background A higher risk of suicidal ideation associated with self-report of Coronavirus Disease 2019 (COVID-19)-like symptoms or COVID-19 infection has been observed in cross-sectional studies, but evidence from longitudinal studies remains limited. The aims of this study were 2-fold: (1) to explore if self-reported COVID-19-like symptoms in 2020 were associated with suicidal ideation in 2021; (2) to explore if the association also existed when using a biological marker of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection in 2020. Methods and findings A total of 52,050 participants from the French EpiCov cohort were included (median follow-up time = 13.7 months). In terms of demographics, 53.84% were women, 60.92% were over 45 years old, 82.01% were born in mainland France from parents born in mainland France, and 59.38% completed high school. COVID-19-like symptoms were defined as participant report of a sudden loss of taste/smell or fever alongside cough, shortness of breath, or chest oppression, between February and November 2020. Symptoms were self-reported at baseline in May 2020 and at the first follow-up in Autumn 2020. Serology-confirmed SARS-CoV-2 infection in 2020 was derived from Spike protein ELISA test screening in dried-blood-spot samples. Samples were collected from October 2020 to March 2021, with 94.4% collected in 2020. Suicidal ideation since December 2020 was self-reported at the second follow-up in Summer 2021. Associations of self-reported COVID-19-like symptoms and serology-confirmed SARS-CoV-2 infection in 2020 with suicidal ideation in 2021 were ascertained using modified Poisson regression models, weighted by inverse probability weights computed from propensity scores. Among the 52,050 participants, 1.68% [1.54% to 1.82%] reported suicidal ideation in 2021, 9.57% [9.24% to 9.90%] had a serology-confirmed SARS-CoV-2 infection in 2020, and 13.23% [12.86% to 13.61%] reported COVID-19-like symptoms in 2020. Self-reported COVID-19-like symptoms in 2020 were associated with higher risks of later suicidal ideation in 2021 (Relative Riskipw [95% CI] = 1.43 [1.20 to 1.69]), while serology-confirmed SARS-CoV-2 infection in 2020 was not (RRipw = 0.89 [0.70 to 1.13]). Limitations of this study include the use of a single question to assess suicidal ideation, the use of self-reported history of mental health disorders, and limited generalizability due to attrition bias. Conclusions Self-reported COVID-19-like symptoms in 2020, but not serology-confirmed SARS-CoV-2 infection in 2020, were associated with a higher risk of subsequent suicidal ideation in 2021. The exact role of SARS-CoV-2 infection with respect to suicide risk has yet to be clarified. Including mental health resources in COVID-19-related settings could encourage symptomatic individuals to care for their mental health and limit suicidal ideation to emerge or worsen.

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Hyper/neuroinflammation in COVID-19 and suicide etiopathogenesis: Hypothesis for a nefarious collision?

Cited by 18 publications

References 196 publications

Adaptor protein MyD88 confers the susceptibility to stress via amplifying immune danger signals

Adaptor protein MyD88 confers the susceptibility to stress via amplifying immune danger signals

COVID-19 illness, SARS-CoV2 infection, and subsequent suicidal ideation in the French nationwide population-based EpiCov cohort : a propensity score analysis of more than 50,000 individuals

Suicidal ideation following self-reported COVID-19-like symptoms or serology-confirmed SARS-CoV-2 infection in France: A propensity score weighted analysis from a cohort study

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