Systemic inflammation and emotional responses during the COVID-19 pandemic

Abstract

The impact of the COVID-19 pandemic on population mental health is of global concern. Inflammatory processes are thought to contribute to mental ill-health, but their role in experiences of psychological distress during the pandemic has not been investigated. We tested the hypothesis that elevated inflammatory biomarkers (high-sensitivity plasma C-reactive protein [CRP] and plasma fibrinogen) measured pre-pandemic would be positively predictive of increased depressive symptoms experienced during the pandemic. Data were analysed from the English Longitudinal Study of Ageing (ELSA), with 3574 individuals aged >50 for CRP and 3314 for fibrinogen measured in waves 8 (2016/17) or 9 (2018/19). Depressive symptoms were measured with a short version of the Centre for Epidemiological Studies Depression Scale (CES-D) pre-pandemic (2016–2019) and during the pandemic (June/July 2020). Participants with higher baseline CRP concentrations had 40% higher odds of developing depressive symptoms during the pandemic (ORadjusted = 1.40, 95% CI 1.12–1.73, p = 0.003) after full adjustment. Fibrinogen concentrations were also associated with depressive symptoms during the pandemic (ORadjusted = 1.23, 95% CI 1.04–1.46, p = 0.019), but this association was no longer significant after controlling for lifestyle factors (smoking status, alcohol consumption and physical activity). In this large population study, systemic inflammation measured 1–3 years pre-pandemic was associated with greater depressed mood during the early months of the pandemic. This finding is consistent with the hypothesis that higher levels of inflammation increase the vulnerability of older people to impaired mental health in the presence of the widespread stress of the COVID-19 pandemic.

The relationship of adverse childhood experiences, hair cortisol, C-reactive protein, and polygenic susceptibility with older adults’ psychological distress during the COVID-19 pandemic

“…No associations were observed between CRP and depression or anxiety. This contradicts a recent ELSA study that identified a relationship between pre-pandemic CRP and depression during the pandemic among older adults [74]. These discrepancies may be due to the current study having a smaller sample size and a larger time gap between the CRP and depression assessments.…”

COVID-19 seroprevalence after the first UK wave of the pandemic and its association with the physical and mental wellbeing of secondary care healthcare workers

“…Whilst poorer mental health was seen throughout the pandemic, it is difficult to link causally to COVID-19 infection, owing to the many, varied other factors associated with the pandemic that could have an impact on an individual's mental well-being. Hamilton et al (2021) , however, found that higher levels of inflammation seen in COVID-19 increase the vulnerability of older people to impaired mental health. An observational study by Magnusdottir et al ( Magnúsdóttir et al, 2022 ) also found that severe acute COVID-19 illness is associated with long term mental health morbidity.…”

Psychic Life-Biological Molecule Bidirectional Relationship: Pathways, Mechanisms, and Consequences for Medical and Psychological Sciences—A Narrative Review

“…The relationships between emotional distress and inflammation were also highlighted in the course of the COVID-19 pandemic [ 78 ]. Alterations in the mental status (i.e., anxiety and depression) present in COVID-19 inpatients were related to higher levels of inflammatory cytokines [ 79 ] and, in particular, showed a clear immune dysregulation recognized from the neutrophil/lymphocyte ratio, which was higher, while IL-10, major anti-inflammatory cytokine, and total lymphocyte counts were lower, compared with not having psychological symptoms [ 80 ].…”

“…Immune dysregulation is particularly dangerous in a viral pandemic, such as COVID-19 [ 109 ]. An experimental study on adult macaques placed in solitary confinement for two weeks, which mimicked human lockdown, showed, already within the first 48 h, a marked reduction in all circulating immune cell populations, and the down-regulation of type I interferon (IFN) anti-viral gene expression [ 78 ].…”