Sorokin Mikhail, Markin Kirill, Trufanov Artem, Bocharova Mariia, Tarumov Dmitriy, Krasichkov Alexander, Shichkina Yulia, Medvedev Dmitriy, Zubova Elena
Institute of Clinical Psychiatry, V.M.Bekhterev National Medical Research Centre for Psychiatry and Neurology, Saint Petersburg, Russia.
Psychiatry Department, Kirov Military Medical Academy, Saint Petersburg, Russia.
Front Psychiatry. 2024 Feb 15;15:1341666. doi: 10.3389/fpsyt.2024.1341666. eCollection 2024.
Factors such as coronavirus neurotropism, which is associated with a massive increase in pro-inflammatory molecules and neuroglial reactivity, along with experiences of intensive therapy wards, fears of pandemic, and social restrictions, are pointed out to contribute to the occurrence of neuropsychiatric conditions.
The aim of this study is to evaluate the role of COVID-19 inflammation-related indices as potential markers predicting psychiatric complications in COVID-19.
A total of 177 individuals were examined, with 117 patients from a temporary infectious disease ward hospitalized due to COVID-19 forming the experimental group and 60 patients from the outpatient department showing signs of acute respiratory viral infection comprising the validation group. The PLR index (platelet-to-lymphocyte ratio) and the CALC index (comorbidity + age + lymphocyte + C-reactive protein) were calculated. Present State Examination 10, Hospital Anxiety and Depression Scale, and Montreal Cognitive Assessment were used to assess psychopathology in the sample. Regression and Receiver operating characteristic (ROC) analysis, establishment of cutoff values for the COVID-19 prognosis indices, contingency tables, and comparison of means were used.
The presence of multiple concurrent groups of psychopathological symptoms in the experimental group was associated (R² = 0.28, F = 5.63, p < 0.001) with a decrease in the PLR index and a simultaneous increase in CALC. The Area Under Curve (AUC) for the cutoff value of PLR was 0.384 (unsatisfactory). For CALC, the cutoff value associated with an increased risk of more psychopathological domains was seven points (sensitivity = 79.0%, specificity = 69.4%, AUC = 0.719). Those with CALC > 7 were more likely to have disturbances in orientation (χ² = 13.6; p < 0.001), thinking (χ² = 7.07; p = 0.008), planning ability (χ² = 3.91; p = 0.048). In the validation group, an association (R² = 0.0775; p = 0.041) between CALC values exceeding seven points and the concurrent presence of pronounced anxiety, depression, and cognitive impairments was demonstrated (OR = 1.52; p = 0.038; AUC = 0.66).
In patients with COVID-19, the CALC index may be used for the risk assessment of primary developed mental disturbances in the context of the underlying disease with a diagnostic threshold of seven points.
诸如冠状病毒嗜神经性等因素，与促炎分子大量增加和神经胶质反应性相关，再加上重症监护病房的经历、对大流行的恐惧以及社会限制，被指出会导致神经精神疾病的发生。
本研究的目的是评估新冠病毒炎症相关指标作为预测新冠病毒感染精神并发症的潜在标志物的作用。
共检查了177人，其中117名因新冠病毒感染而入住临时传染病病房的患者组成实验组，60名来自门诊且有急性呼吸道病毒感染迹象的患者组成验证组。计算血小板与淋巴细胞比值（PLR指数）和合并症+年龄+淋巴细胞+C反应蛋白（CALC指数）。使用现状检查10、医院焦虑抑郁量表和蒙特利尔认知评估来评估样本中的精神病理学。采用回归分析、受试者工作特征（ROC）分析、确定新冠病毒感染预后指标的临界值、列联表分析和均值比较。
实验组中多种并发的精神病理症状群的存在与PLR指数降低及CALC指数同时升高相关（R² = 0.28，F = 5.63，p < 0.001）。PLR临界值的曲线下面积（AUC）为0.384（不理想）。对于CALC，与更多精神病理领域风险增加相关的临界值为7分（敏感性 = 79.0%，特异性 = 69.4%，AUC = 0.719）。CALC>7的患者更有可能出现定向障碍（χ² = 13.6；p < 0.001）、思维障碍（χ² = ......（此处原文似乎不完整）......7.07；p = 0.008）、计划能力障碍（χ² = 3.91；p = 0.048）。在验证组中，CALC值超过7分与同时存在明显焦虑、抑郁和认知障碍之间存在关联（R² = 0.0775；p = 0.041）（OR = 1.52；p = 0.038；AUC = 0.66）。
在新冠病毒感染患者中，CALC指数可用于在基础疾病背景下对原发性精神障碍发生风险进行评估，诊断阈值为7分。
