Correlation of clinical and biological parameters in endogenous psychoses developed after coronavirus infection (COVID-19)

Abstract

Introduction The importance of inflammation as a common pathophysiological mechanism underlying infectious and non-infectious diseases determines the relevance of studying the effect of coronavirus infection (COVID-19) on the course of endogenous psychoses. Objectives Clinical and immunological study of the potential impact of coronavirus infection on the course of endogenous psychoses. Methods Two groups of female patients aged 16 to 48 years with depressive-delusional conditions (F20.01, F21, F31) developed after a coronavirus infection were examined. In 15 patients, psychosis developed 1-2 months after COVID-19, and in 18 patients it occured within 2-6 months after the disease. The severity of psychopathological symptoms was assessed using PANSS and HDRS-21 scales. The activity of inflammatory markers leukocyte elastase (LE) and α1-proteinase inhibitor (α1-PI) in the blood of patients was determined. Neutrophil count, lymphocyte count and neutrophil/lymphocyte ratio were calculated. The standard values of indicators of healthy donors corresponding to patients by age and sex were used as controls. Results Endogenous psychoses that developed later after coronavirus infection were associated with “typical” inflammation, increased α1-PI activity and increased neutrophil degranulation (by LE activity) compared to normal values. Patients with this immune profile were observed to develop depressive-delusional states with a prevalence of positive affectivity (anxiety, melancholy) and an expanded nature of delusional disorders that were predominantly non-congruent with affect. Endogenous psychoses that developed within 2-6 months after COVID-19 were characterized by decreased neutrophil count, decreased LE activity, prevalence of negative affectivity (apathy, asthenia, adynamia), and a relatively undeveloped nature of delusional disorders that were predominantly congruent with affect. Conclusions Clinical and biological correlates presumably indicate the modulating effect of the coronavirus infection on (neuro)inflammation and the structure of endogenous psychoses. Disclosure of Interest None Declared