PSYCHIATRIC SYMPTOMS IN COVID-19 PATIENTS AND FACTORS ASSOCIATED WITH THESE SYMPTOMS: COULD PERIPHERAL INFLAMMATION MARKERS BE ONE OF THEM ?

Abstract

OBJECTIVE: In addition to respiratory symptoms, there have been reports of increased psychiatric symptoms in COVID-19 patients. In this study, it is aimed to reveal the psychiatric symptoms seen in COVID-19 patients. We also investigated the relationship between these psychiatric symptoms and peripheral inflammatory markers. MATERIAL AND METHODS: The patients were evaluated with "Interview Forms" specially created by the researchers for the study. DSM-V Acute Stress Disorder Scale (ASDS); Perceived Stress Scale-10 (PSS-10); State-Trait Anxiety Inventory (STAI-T/S); and finally Hospital Anxiety and Depression Scale (HADS) were used to determine patients' acute and perceived stress levels, depression and anxiety symptoms, state and generalized anxiety levels, and how these psychiatric symptoms were affected by different social conditions. D-dimer, fibrinogen, lymphocytes, CRP (C-reactive protein) and ferritin levels were taken into account as inflammatory markers. RESULTS: Our study included 108 inpatients and 31 outpatients with COVID-19. The ASDS, STAI State Scale, and HADS depression scale scores of inpatients patients were found to be higher compared to outpatient patients. Increased fibrinogen levels in blood tests were found to predict higher acute stress disorder scores. HAD-Depression subscale and fibrinogen levels were also found to be positively correlated with each other. CONCLUSIONS: Stress, depression and anxiety symptoms accompany COVID-19. In addition, high fibrinogen levels may be associated with psychiatric symptoms. Psychiatric symptoms are indirectly affected by physical illnesses. We can say that a pandemic that causes fear and anxiety all over the world may suppress the immune system in individuals and the suppressed immune system may indirectly make the infection more complicated.

Keywords

• COVID-19
• Anxiety
• Depression
• Inflammation

COVID-19 HASTALARINDA PSİKİYATRİK BELİRTİLER VE BU BELİRTİLERLE İLİŞKİLİ FAKTÖRLER: PERİFERİK İNFLAMASYON BELİRTEÇLERİ BUNLARDAN BİRİ OLABİLİR Mİ ?

Abstract

AMAÇ: Solunum semptomlarına ek olarak, COVID-19 hastalarında psikiyatrik semptomların da arttığına dair veriler bildirilmiştir. Bu çalışmada COVID-19 hastalarında görülen psikiyatrik belirtilerin ortaya konması amaçlanmıştır. Ayrıca bu psikiyatrik semptomlar ile periferik inflamatuar belirteçler arasındaki ilişki araştırılmıştır. GEREÇ VE YÖNTEM: Hastalar çalışma için araştırıcılar tarafından özel oluşturulmuş “Görüşme Formları” ile değerlendirildi. Hastaların akut ve algılanan stres düzeylerini, depresyon ve anksiyete belirtilerini, durumsal ve genelleştirilmiş kaygı düzeylerini ve bu psikiyatrik belirtilerin farklı sosyal koşullardan nasıl etkilendiğini belirlemek için DSM-V Akut Stres Bozukluğu Ölçeği (ASBÖ); Algılanan Stres Ölçeği-10 (PSS-10); Durumluk-Sürekli Kaygı Envanteri (STAI-T/S); ve son olarak Hastane Anksiyete ve Depresyon Ölçeği (HADÖ) kullanıldı. İnflamatuar belirteçlerden D-dimer, fibrinojen, lenfositler, CRP (C-reaktif protein) ve ferritin seviyeleri dikkate alındı. BULGULAR: Araştırmamıza 108 yatan, 31 ayaktan izlemi devam eden COVİD 19 hastası dahil edilmiştir. Yatan hastaların ASBÖ, STAİ Süreklilik Ölçeği ve HADS (Hastane Anksiyete Depresyon Skalası) puanları, ayaktan hastalara göre daha yüksek tespit edilmiştir. Kan testlerinde artmış fibrinojen seviyelerinin daha yüksek akut stres bozukluğu skorlarını öngördüğü bulunmuştur. HADS-Depresyon alt ölçeği ve fibrinojen düzeyleri de birbiriyle pozitif korelasyon gösterdiği bulunmuştur. SONUÇ: Stres, depresyon ve anksiyete belirtileri COVID-19'a eşlik etmektedir. Ayrıca yüksek fibrinojen düzeyleri psikiyatrik belirtilerle ilişkili olabilir. Psikiyatrik belirtiler fiziksel hastalıklardan dolaylı olarak etkilenir. Tüm dünyada korku ve endişeye neden olan bir salgının bireylerde bağışıklık sistemini baskılayabileceğini ve baskılanan bağışıklık sisteminin dolaylı olarak enfeksiyonu daha da karmaşık hale getirebileceğini söyleyebiliriz.

Keywords

• COVID-19
• Anksiyete
• Depresyon İnflamasyon

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