The impact of inflammatory and metabolic markers on depression, anxiety, and cognition after COVID-19: a narrative review

Trends Psychiatry Psychother. 2024:46:e20220599. doi: 10.47626/2237-6089-2022-0599. Epub 2023 Jun 26.

Abstract

Objectives: There has been growing concern about the long-term effects of coronavirus disease 2019 (COVID-19) on mental health. The biological factors common to psychiatric conditions and COVID-19 are not yet fully understood.

Methodos: We narratively reviewed prospective longitudinal studies that measured metabolic or inflammatory markers and assessed psychiatric sequelae and cognitive impairment in individuals with COVID-19 at least 3 months after infection. A literature search identified three relevant cohort studies.

Results: Overall, depressive symptomatology and cognitive deficits persisted for up to 1 year after COVID-19; depression and cognitive changes were predicted by acute inflammatory markers, and changes in these markers correlated with changes in depressive symptomatology; female sex, obesity, and the presence of inflammatory markers were associated with more severe clusters of physical and mental health status in patients' self-perceived recovery; and plasma metabolic profiles of patients continued to differ from those of healthy controls 3 months after hospital discharge, which were associated with widespread alterations in neuroimaging, reflecting issues with white matter integrity.

Conclusion: In individuals affected by COVID-19, prolonged exposure to stress and alterations in metabolic and inflammatory markers play a central role in psychiatric sequelae and cognitive deficits in the long term.

Keywords: COVID-19; anxiety; cognitive impairment; depression; inflammation; metabolomics.

Publication types

  • Review

MeSH terms

  • Anxiety / etiology
  • Biomarkers* / blood
  • COVID-19* / complications
  • COVID-19* / psychology
  • Cognitive Dysfunction / blood
  • Cognitive Dysfunction / etiology
  • Depression* / blood
  • Depression* / etiology
  • Humans
  • Inflammation / blood

Substances

  • Biomarkers