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 (265male,meanage58), 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 obervation 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.

中文翻译：

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COVID-19 幸存者的焦虑和抑郁：炎症和临床预测因素的作用

摘要 感染引发的免疫系统扰动可能引发精神病理学，并且在之前的冠状病毒爆发后观察到精神后遗症。严重急性呼吸系统综合症冠状病毒（COVID-19）大流行的传播可能与精神病学影响有关。我们调查了 COVID-19 对幸存者的心理病理影响，同时考虑了临床和炎症预测因素的影响。我们在医院治疗后一个月的随访中对 402 名幸存的 COVID-19 成年人（265 名男性，平均 58 岁）进行了精神症状筛查。使用临床访谈和一系列自我报告问卷来调查创伤后应激障碍（PTSD）、抑郁、焦虑、失眠和强迫症（OC）症状。我们收集了社会人口统计信息、临床数据、基线炎症标志物和随访氧饱和度水平。很大一部分患者在精神病理学范围内进行自我评估：28% 患有创伤后应激障碍 (PTSD)，31% 患有抑郁症，42% 患有焦虑症，20% 患有强迫症症状，40% 患有失眠症。总体而言，56% 的患者至少在一个临床维度上得分处于病理范围内。尽管基线炎症标志物水平显着较低，但女性的焦虑和抑郁症状更严重。既往精神科诊断呈阳性的患者在大多数精神病理学指标上的得分均有所增加，并且基线炎症情况相似。基线全身免疫炎症指数（SII）根据外周淋巴细胞、中性粒细胞和血小板计数反映免疫反应和全身炎症，与随访时的抑郁和焦虑评分呈正相关。创伤后应激障碍（PTSD）、重度抑郁症和焦虑症都是与多年残疾相关的高负担非传染性疾病。考虑到 COVID-19 感染对心理健康的惊人影响、当前对精神病学炎症的见解，以及目前观察到的更严重的炎症会导致更严重的抑郁症，我们建议评估 COVID-19 幸存者的精神病理学，并深化对炎症生物标志物的研究，以便诊断和治疗紧急精神疾病。