Psychiatry & Clinical Psychobiology Unit, Division of Neuroscience, IRCCS San Raffaele Hospital, Milano, Italy.
Psychiatry & Clinical Psychobiology Unit, Division of Neuroscience, IRCCS San Raffaele Hospital, Milano, Italy; University Vita-Salute San Raffaele, Milano, Italy.
Behav Brain Res. 2025 Jan 5;476:115275. doi: 10.1016/j.bbr.2024.115275. Epub 2024 Sep 25.
SARS-CoV-2 affects brain, body, and their interchange. We investigated interoceptive mechanisms in COVID-19 survivors focusing on their potential link with psychopathology and inflammatory biomarkers.
We assessed interoceptive accuracy (IAc) and time-perceiving (TA) skills of 57 COVID-19 survivors one month after hospital discharge through, respectively, a heartbeats perception task and a time duration task. Each participant was assessed about his interoceptive awareness (IAw) through Multidimensional Assessment of Interoceptive Awareness questionnaire (MAIA) and then, screened for post-traumatic (Impact of Events Scale - IES-R), anxious (State-Trait Anxiety Inventory - STAI-Y1) and depressive (Zung Self-Rating Depression Scale - ZSDS; Beck Depression Inventory - BDI-13) symptoms. Biomarkers of inflammation (platelet count, PC; mean platelet volume, MPV and systemic immune-inflammation index, SII) were obtained in a subsample of 40 survivors by a blood sampling conducted at admission and discharge time from the hospital. Correlational, GLM, GLMZ, and mediation analyses were performed.
IAc did not correlate with TA confirming the reliability of interoceptive measure. IAc positively predicts MAIA's Trusting subscale and negatively predicts anxious psychopathology which fully mediates the effect of IAc on Trusting.PC at hospital admission predicts anxiety at one month after recovery. Again, a higher decrease of SII during hospitalization predicts higher IAc skill and lower anxiety state at one month. The link between SII change and anxiety is fully mediated by IAc.
Our results unveil a potential key role of interoception and brain-body interchange in the exacerbation and maintenance of anxiety psychopathology in COVID-19 survivors.
SARS-CoV-2 会影响大脑、身体及其相互作用。我们研究了 COVID-19 幸存者的内脏感觉机制，重点关注它们与精神病理学和炎症生物标志物的潜在联系。
我们通过心跳感知任务和时间感知任务，分别评估了 57 名 COVID-19 幸存者在出院后一个月的内脏感觉准确性（IAc）和时间感知（TA）技能。每位参与者通过多维内脏感觉意识问卷（MAIA）评估其内脏感觉意识（IAw），然后通过创伤后应激量表（IES-R）、状态-特质焦虑量表（STAI-Y1）和抑郁自评量表（ZSDS；贝克抑郁量表-13 项）筛查焦虑和抑郁症状。在 40 名幸存者的亚样本中，通过在入院和出院时进行血液采样获得炎症生物标志物（血小板计数、PC；平均血小板体积、MPV 和全身免疫炎症指数、SII）。进行了相关分析、GLM、GLMZ 和中介分析。
IAc 与 TA 不相关，这证实了内脏感觉测量的可靠性。IAc 正预测 MAIA 的信任子量表，负预测焦虑精神病理学，这完全中介了 IAc 对信任的影响。入院时的 PC 预测出院后一个月的焦虑。同样，住院期间 SII 的下降幅度越大，IAc 技能越高，出院后一个月的焦虑状态越低。SII 变化与焦虑之间的联系完全由 IAc 介导。
我们的结果揭示了内脏感觉和大脑-身体相互作用在 COVID-19 幸存者中焦虑精神病理学恶化和维持中的潜在关键作用。
