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The Impact of Hyper-Acute Inflammatory Response on Stress Adaptation and Psychological Symptoms of COVID-19 Patients

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  • Ion Papava

    (Department of Neurosciences-Psychiatry, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
    Center for Cognitive Research in Neuropsychiatric Pathology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
    Department of Psychiatry, Timis County Emergency Clinical Hospital “Pius Brinzeu”, Liviu Rebreanu 156, 300723 Timisoara, Romania
    These authors contributed equally to this work.)

  • Liana Dehelean

    (Department of Neurosciences-Psychiatry, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
    Center for Cognitive Research in Neuropsychiatric Pathology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
    Department of Psychiatry, Timis County Emergency Clinical Hospital “Pius Brinzeu”, Liviu Rebreanu 156, 300723 Timisoara, Romania)

  • Radu Stefan Romosan

    (Department of Neurosciences-Psychiatry, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
    Center for Cognitive Research in Neuropsychiatric Pathology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
    Department of Psychiatry, Timis County Emergency Clinical Hospital “Pius Brinzeu”, Liviu Rebreanu 156, 300723 Timisoara, Romania)

  • Mariana Bondrescu

    (Department of Neurosciences-Psychiatry, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
    Department of Psychiatry, Timis County Emergency Clinical Hospital “Pius Brinzeu”, Liviu Rebreanu 156, 300723 Timisoara, Romania
    Doctoral School, University of Medicine and Pharmacy “Victor Babes” Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania)

  • Cristian Zoltan Dimeny

    (Department of Psychiatry, Timis County Emergency Clinical Hospital “Pius Brinzeu”, Liviu Rebreanu 156, 300723 Timisoara, Romania)

  • Eugenia Maria Domuta

    (Surgery Department, Faculty of Medicine and Pharmacy, University of Oradea, Piata 1 Decembrie 10, 410073 Oradea, Romania
    These authors contributed equally to this work.)

  • Felix Bratosin

    (Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania)

  • Iulia Bogdan

    (Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania)

  • Mirela Loredana Grigoras

    (Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
    Department of Anatomy and Embryology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania)

  • Codruta Victoria Tigmeanu

    (Department of Technology of Materials and Devices in Dental Medicine, Multidisciplinary Center for Research, Evaluation, Diagnosis and Therapies in Oral Medicine, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania)

  • Angelica Gherman

    (Research Center for Medical Communication, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania)

  • Iosif Marincu

    (Surgery Department, Faculty of Medicine and Pharmacy, University of Oradea, Piata 1 Decembrie 10, 410073 Oradea, Romania)

Abstract

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection induces a significant inflammatory response that are amplified by persistent stress. The pathophysiology of mental illnesses is explored in terms of inflammatory processes. Thus, anxious, depressed, or psychotic episodes may occur as a result of metabolic and immunological imbalances, as a direct result of their effect on the central nervous system, or as a side effect of the COVID-19 medication protocols. As such, the primary objective of this research is to establish if the psychological profiles of COVID-19 patients change substantially according to illness severity. The secondary objective is to determine if particular biological inflammatory indicators are associated with anxiety, sadness, psychoticism, and paranoid ideation. A cross-sectional study was performed on 90 hospitalized patients admitted during a 3-month period in the COVID-19 unit. All patients received the COPE-60 and SCL-90R questionnaires. Clinical and paraclinical data were collected and the information was classified according to the severity of COVID-19.The hyper-acute inflammation encountered in patients with severe COVID-19 infection characterized 80.0% of patients using disengagement coping methods, significantly more than patients with mild or moderate SARS-CoV-2 infection severity ( p -value = 0.012), respectively, 73.3% severe COVID-19 patients engaging in emotion-focused coping strategies based on the COPE-60 scale ( p -value = 0.037). Additionally, it was determined that negative coping mechanisms (disengagement) and emotion-focused methods are independent risk factors for developing psychoticism symptoms following acute SARS-CoV-2 infection, based on the SCL-90 questionnaire (OR = 2.07; CI = 1.44–3.01), respectively (OR = 2.92; CI = 1.44–3.01). Elevated white blood cells and monocytes and inflammatory markers, such as fibrinogen, procalcitonin, IL-6, and D-dimers, were also identified as risk factors for psychoticism symptoms in multivariate analysis. It is particularly important to consider the constant mental-state evaluation in patients with severe COVID-19 that might benefit from early intervention before psychotic symptoms onset.

Suggested Citation

  • Ion Papava & Liana Dehelean & Radu Stefan Romosan & Mariana Bondrescu & Cristian Zoltan Dimeny & Eugenia Maria Domuta & Felix Bratosin & Iulia Bogdan & Mirela Loredana Grigoras & Codruta Victoria Tigm, 2022. "The Impact of Hyper-Acute Inflammatory Response on Stress Adaptation and Psychological Symptoms of COVID-19 Patients," IJERPH, MDPI, vol. 19(11), pages 1-12, May.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:11:p:6501-:d:825079
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    References listed on IDEAS

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    1. Caroline Gurvich & Natalie Thomas & Elizabeth HX Thomas & Abdul-Rahman Hudaib & Lomash Sood & Kali Fabiatos & Keith Sutton & Anton Isaacs & Shalini Arunogiri & Gemma Sharp & Jayashri Kulkarni, 2021. "Coping styles and mental health in response to societal changes during the COVID-19 pandemic," International Journal of Social Psychiatry, , vol. 67(5), pages 540-549, August.
    2. Joshua R. Goldstein & Ronald D. Lee, 2020. "Demographic perspectives on the mortality of COVID-19 and other epidemics," Proceedings of the National Academy of Sciences, Proceedings of the National Academy of Sciences, vol. 117(36), pages 22035-22041, September.
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