Diniz Elton Jorge Bessa, Scorza Fulvio Alexandre, Rodrigues Fabrício Maués Santos, de Mello Claudia Berlim, Bonetti Tatiana Carvalho de Souza, Bortoluci Karina Ramalho, Mari Jair de Jesus
Departamento de Psiquiatria e Psicologia Médica, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
Disciplina de Neurociências, Departamento de Neurologia/Neurocirurgia, EPM, UNIFESP, São Paulo, SP, Brazil.
Trends Psychiatry Psychother. 2024;46:e20220599. doi: 10.47626/2237-6089-2022-0599. Epub 2023 Jun 26.
There has been growing concern about the long-term effects of coronavirus disease 2019 (COVID-19) on mental health. The biological factors common to psychiatric conditions and COVID-19 are not yet fully understood.
We narratively reviewed prospective longitudinal studies that measured metabolic or inflammatory markers and assessed psychiatric sequelae and cognitive impairment in individuals with COVID-19 at least 3 months after infection. A literature search identified three relevant cohort studies.
Overall, depressive symptomatology and cognitive deficits persisted for up to 1 year after COVID-19; depression and cognitive changes were predicted by acute inflammatory markers, and changes in these markers correlated with changes in depressive symptomatology; female sex, obesity, and the presence of inflammatory markers were associated with more severe clusters of physical and mental health status in patients' self-perceived recovery; and plasma metabolic profiles of patients continued to differ from those of healthy controls 3 months after hospital discharge, which were associated with widespread alterations in neuroimaging, reflecting issues with white matter integrity.
In individuals affected by COVID-19, prolonged exposure to stress and alterations in metabolic and inflammatory markers play a central role in psychiatric sequelae and cognitive deficits in the long term.
人们越来越关注2019冠状病毒病（COVID-19）对心理健康的长期影响。精神疾病和COVID-19共有的生物学因素尚未完全明确。
我们对前瞻性纵向研究进行了叙述性综述，这些研究测量了代谢或炎症标志物，并在感染COVID-19至少3个月后评估了个体的精神后遗症和认知障碍。文献检索确定了三项相关队列研究。
总体而言，COVID-19后抑郁症状和认知缺陷持续长达1年；急性炎症标志物可预测抑郁和认知变化，这些标志物的变化与抑郁症状的变化相关；女性、肥胖以及炎症标志物的存在与患者自我感知恢复中更严重的身心健康状况集群相关；出院3个月后，患者的血浆代谢谱仍与健康对照不同，这与神经影像学的广泛改变有关，反映了白质完整性问题。
在受COVID-19影响的个体中，长期暴露于压力以及代谢和炎症标志物的改变在精神后遗症和长期认知缺陷中起核心作用。
