Evaluation of copeptin and psychological stress among healthcare providers during COVID-19 pandemic

Abstract

Background:The COVID-19 pandemic created a remarkable impact on healthcare providers (HCP) both physically and psychologically. Perceived psychological stress (PSS) influences the homeostatic equilibrium, involving activation of the sympathetic nervous system and hypothalamus pituitary adrenal (HPA) axis. Copeptin, C-terminal portion of Vasopressin (AVP) precursor is stable; however, evidence about impact of PSS on copeptin levels is limited. Aim: The aim of this study was to estimate the influence of psychological stress on copeptin levels among HCP working in intensive care unit (ICU). Methods: A total of 70 HCP served in quarantine ICU participated in this prospective study; 35 physicians (28 males and 7 females) and 35 nurses (10 males and 25 females). A control group of 40 HCP matched age, BMI and specialty in non-quarantine hospitals. Fasting morning blood samples were withdrawn for determination of copeptin, cortisol, insulin at three points; prequarantine at ICU. Second point at end of first week and third point was two weeks' post quarantine. A questionnaire was conducted to all participants to assess stress (PSS). Cortisol was determined by a chemiluminescence immunoassay while insulin and Copeptin were measured by ELISA. Results: Baseline plasma copeptin level pre-quarantine was significantly increased 15.76 ± 8.6 pmol/l (P = 0.001*) and was positively correlated with high stress PSS score mean 66.9 ± 18.3. Post-quarantine copeptin was markedly reduced 3.98 ± 1.28 pmol/l and mean PSS was 23.0 ± 7.95 (P = 0.001*). Also, there was positive correlation between plasma copeptin and PSS, systolic blood pressure and serum insulin. On the other hand, there was no correlation between copeptin and serum cortisol. Conclusion:Our finding suggested that copeptin may be used a potential biomarker for physiological strain during work in a stressful environment.

High level of psychological stress in COVID-19 recovered individuals: role of copeptin as a potential biomarker

“…We found that serum copeptin levels were significantly higher in those with moderate and severe stress as compared to those with mild stress following recovery from COVID. Demerdash and co-workers studied stress in healthcare workers involved in the care of COVID-19 by measuring stress by perceived stress score (PSS) questionnaire and copeptin ( Demerdash et al, 2021 ). The study revealed that baseline copeptin levels pre-quarantine were significantly increased and positively correlated with high stress.…”

“…The study revealed that baseline copeptin levels pre-quarantine were significantly increased and positively correlated with high stress. A decline in serum copeptin and PSS was observed following a decrease in stress post-quarantine ( Demerdash et al, 2021 ). The role of copeptin as a stress biomarker in subjects who had recovered from COVID has not been explored so far.…”

“…A sample size of 60 subjects was required for PSS-10 assessment. It was based on; a standard deviation of 18.3 reported in previous study ( Demerdash et al, 2021 ). Two sided significance level of 5 and 80% power of study were taken into account.…”

Copeptin: A Neuroendocrine Biomarker of Covid-19 Severity

“…Endocrine stress conditioning is mediated by many hormones, including the AVP and cortisol through the activation of the hypothalamic–adenohypophyseal axis. Copeptin is a biochemical mirror to the AVP as being synthesized from the same ancestor gene, preproprotein precursor and stoichiometrically released, in addition to being remarkably stable in blood samples with the easier biochemical assay [ 16 , 17 ].…”

“…Together with AVP, copeptin is secreted in an equimolar amount from the neurohypophysis in response to AVP release stimulating conditions [ 15 ]. Due to the short half-life and instability of AVP in blood, copeptin is a preferred sensitive and stable surrogate biomarker for estimating AVP release [ 16 , 17 ].…”