Investigation of the relationship between anxiety-depression, systemic immune-inflammation index and clinical progression in COVID-19.

Abstract

Objective: Given the multisystem nature of COVID-19 and its potential neuro-psychiatric effects along with the recognized role of systemic inflammation in the prognosis of both COVID-19 and psychiatric disorders, it is imperative to assess psychiatric symptoms in COVID-19 patients. This study sought to investigate the value of systemic immune-inflammation index (SII) scores, levels of anxiety and depressive symptoms assessed within the initial 24 hours following COVID-19 diagnosis as potential predictors of the clinical trajectory of COVID-19.

Methods: This study involved 64 patients admitted to our COVID-19 ward with mild-to-moderate COVID-19 pneumonia, all of whom underwent a psychiatric evaluation within 24 hours of admission. Upon admission, levels of c-reactive protein and inflammatory markers including leukocyte, neutrophil, thrombocyte, and lymphocyte counts were measured to calculate individual SII scores. Psychiatric evaluations were conducted using the State-Trait Anxiety Inventory (STAI), Hamilton Depression Rating Scale (HDRS), and Standardized Mini-Mental Test (SMMT).

Results: The patients with clinical deterioration of COVID-19 exhibited higher STAI-Trait and STAI-State subscale scores measured upon admission compared to those without clinical deterioration. HDRS scores showed no significant correlation with clinical deterioration. STAI-State subscale scores correlated with SII scores and the duration of hospital stay. High baseline STAI scores and SII scores predicted COVID-19 clinical deterioration.

Conclusion: Our study demonstrated that the initial SII and STAI scores assessed within the initial 24 hours of hospitalization for COVID-19 significantly predicted the clinical progression of the disease during the hospital stay (Tab. 5, Ref. 37). Text in PDF www.elis.sk Keywords: COVID-19, systemic inflammatory response index, disease severity, inflammation.