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新冠疫情期间医护人员的心理健康:一项关于监测风险认知及与基于血液的细胞外囊泡炎症关系影响的研究。

Mental health among healthcare workers during COVID-19: a study to oversee the impact of the risk perception and relationship with inflammation from blood-based extracellular vesicles.

作者信息

Canivet Coraline, Hébert Thalie, Boilard Eric, Morin Charles M, Deslauriers Jessica

机构信息

Neurosciences Axis, Centre de Recherche du Centre Hospitalier Universitaire (CRCHU) de Québec-Université Laval, Québec City, QC, Canada.

Infectious and Inflammatory Diseases Axis, CRCHU de Québec-Université Laval, Québec City, QC, Canada.

出版信息

Front Public Health. 2025 Aug 21;13:1560129. doi: 10.3389/fpubh.2025.1560129. eCollection 2025.

Abstract

INTRODUCTION

Preventive measures have been implemented in hospitals during COVID-19, but how these guidelines affected mental health among healthcare workers (HCWs) remains to be determined. On another note, reliable psychological and blood-based markers are needed to promptly identify HCWs at-risk to develop distress. Extracellular vesicles (EVs) originating from brain cross the blood-brain barrier and are detectable in blood, giving them a highly valuable potential for biomarker discovery. In HCWs with or without psychological distress, we investigated how perceived stress during COVID-19 impacted mental health. We then longitudinally evaluated the inflammatory cargo from neuron-, astrocyte-, and microglial-derived EVs that may be associated with psychological distress.

METHODS

Our prospective study that included an initial visit (02/2021-08/2021), and two follow-up visits 3 and 6 months later (last visit; 03/2022). HCWs ( = 15) completed questionnaires for perception of risk, COVID-19-specific posttraumatic symptomatology, psychological distress and burnout, as well as sleep quality. Blood was collected at each visit to characterizing inflammation from brain-derived EVs. Multiple regressions were conducted for all psychological/biological parameters based on the HCWs' final score for psychological distress.

RESULTS

Onset of psychological distress was associated early hyperarousal. Moreover, severe distress was associated with increased astrocyte-specific levels of anti-inflammatory interleukin-10 and pro-inflammatory interferon-ɣ.

DISCUSSION

Our findings-that need to be replicated in larger studies-suggest that early hyperarousal may be predictive of later onset of psychological distress in HCWs. They also unravel a novel area of biomarker discovery study in psychiatry as inflammation from brain-derived EVs could help targeting "at-risk" individuals.

摘要

引言

在新冠疫情期间,医院已实施了预防措施,但这些指南对医护人员心理健康的影响仍有待确定。另一方面,需要可靠的心理和血液标志物来及时识别有出现心理困扰风险的医护人员。源自大脑的细胞外囊泡(EVs)可穿过血脑屏障并在血液中被检测到,这使其在生物标志物发现方面具有极高的潜在价值。在有或没有心理困扰的医护人员中,我们研究了新冠疫情期间感知到的压力如何影响心理健康。然后,我们纵向评估了可能与心理困扰相关的神经元、星形胶质细胞和小胶质细胞衍生的EVs中的炎症成分。

方法

我们的前瞻性研究包括一次初始访视(2021年2月至2021年8月),以及3个月和6个月后的两次随访(最后一次访视;2022年3月)。15名医护人员完成了关于风险感知、新冠疫情特定创伤后症状、心理困扰和职业倦怠以及睡眠质量的问卷调查。每次访视时采集血液,以表征源自大脑的EVs的炎症情况。基于医护人员心理困扰的最终得分,对所有心理/生物学参数进行多元回归分析。

结果

心理困扰的发作与早期过度唤醒有关。此外,严重困扰与星形胶质细胞特异性的抗炎白细胞介素-10和促炎干扰素-γ水平升高有关。

讨论

我们的研究结果——需要在更大规模的研究中进行重复验证——表明早期过度唤醒可能预示着医护人员随后会出现心理困扰。这些结果还揭示了精神病学中生物标志物发现研究的一个新领域,因为源自大脑的EVs中的炎症可能有助于确定“高危”个体。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3023/12408313/dc879b419dab/fpubh-13-1560129-g001.jpg

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