Correlation of Inflammatory Biomarkers with Neuropsychological Performance of COVID-19 Survivors After ICU Discharge: 20 Months Follow-up

Abstract

Background: COVID-19 infection may be related to development of neural damage and neural inflammation. Accumulating evidence highlighted the high prevalence of long-term mental health problems among COVID-19 survivors.Aim: The present study was conducted with aim to evaluate the long-term psychosomatic effects of COVID-19 and their relationship with inflammatory biomarkers among COVID-19 survivors after ICU discharge.Method: This prospective study was conducted on patients discharged from the COVID-19 intensive care unit (ICU) between June and August 2021. Depression, anxiety, health anxiety, sleep quality and cognitive abilities were assessed. Also, inflammatory biomarkers including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Neutrophil-to-lymphocyte ratio (NLR), ferritin and D-dimer were measured. Data were analyzed using SPSS (version 22.0) and Pearson correlation analysis and multiple linear regression analysis. p<0.05 was considered significant.Results: Among 78 survivors, 26% and 45.5% had moderate/severe degree of depressive and anxiety symptoms, respectively. Moreover, 25% of participants reported health anxiety and 61.8% poor sleep quality. The cognitive abilities had a significant inverse correlation with D-dimer level (r=-0.44, p<0.001). Moreover, BDI-II score was significantly correlated with ESR level (r=0.29, p<0.06). The only factor associated with BDI-II depression score was ESR levels (β=0.37, p=0.013). D-dimer was independently associated with cognitive abilities score (β=-0.45, p=0.001).Implications for Practice: Although there was a high prevalence of mental disorders among patients discharged from COVID-19 ICUs even after 20 months, our results do not support a dominant role for inflammatory background (during acute phase of COVID-19) to explain the neuropsychological impairments long time after COVID-19 infection.