Inflammation and Long-Term Mental Health Outcomes in Post-COVID-19 Patients: A Follow-Up Study
A. Duque Guerra, J. Pérez-Blanco, E. Grasa, G. Riquelme, F. Vidal-Domènech, M. Sanmartí, V. Diaz-Brito, A. Barajas, J. López-Contreras, B. RamosIntroduction
The COVID-19 pandemic has been associated with increased rates of depression, anxiety, and post-traumatic stress disorder (PTSD). While systemic inflammation during acute infection has been proposed as a biological mechanism, its relationship with long-term mental health outcomes remains unclear. This study investigates psychiatric symptoms and their association with inflammation and illness severity between 24 and 36 months after COVID-19.
Objectives
To evaluate the prevalence of psychiatric symptoms (depression, psychological distress, and post-traumatic symptoms) 24–36 months after COVID-19 infection.
To examine the association between inflammatory markers (measured during the acute phase and at long-term follow-up) and psychiatric outcomes.
To explore the relationship between COVID-19 severity and psychiatric symptoms.
Methods
A multicenter observational cohort study enrolled 92 Spanish patients with confirmed SARS-CoV-2 infection. Inflammatory markers (C-reactive protein levels, neutrophil-to-lymphocyte ratio, systemic immune-inflammation index, platelet counts) were measured during acute illness and reassessed between 24 and 36 months after infection. Psychiatric symptoms at two years were assessed using the Beck Depression Inventory-II (BDI-II), Symptom Checklist-90-Revised (SCL-90-R) for psychological distress, and Davidson Trauma Scale (DTS). COVID-19 severity was classified according to WHO criteria.
Results
15% of patients showed mild depression level, 21 % of the patients had post-traumatic symptoms, while 28% of patients had psychological distress with somatization and obsessive-compulsive symptoms being most prevalent. Platelet counts during the acute phase were the only inflammatory parameter significantly associated with higher SCL-90-R scores for somatic and anxiety-related psychological distress. No significant associations were found between inflammatory markers—either during the acute phase or at follow-up—and psychiatric symptoms measured by the BDI-II and DTS. COVID-19 severity was correlated with increased obsessive–compulsive, somatic, and anxiety-related symptoms on the SCL-90-R.
Conclusions
Between 15% and 28% of patients presented psychiatric symptoms, with psychological distress being the most consistent finding. Furthermore, obsessive–compulsive, somatic, and anxiety-related symptoms were associated with COVID-19 severity. These findings highlight the need for ongoing psychological monitoring and comprehensive approaches to understanding and supporting post-COVID mental health.
Disclosure of Interest
None Declared