Covid, after severe forms of depression and brain alterations

Depression, anxiety and post-traumatic stress syndrome, associated with real alterations of the brain, visible on MRI. Even these consequences – whose duration is still to be understood – can be met by those who become ill with Covid developing severe forms, characterized by high levels of inflammation. A study by the San Raffaele hospital in Milan, published in ‘Brain, Behavior, & Immunity – Health ‘by the research group in Psychiatry and Clinical Psychobiology of IRCCS, directed by Francesco Benedetti, psychiatrist and associate professor at the Vita-Salute San Raffaele University. The work underlines “the importance of carefully following the course of Covid-19 patients even after discharge – they explain from the hospital – and confirms the risk factor represented by serious infections, and the related inflammatory responses, in the onset of disorders anxiety and mood “even in people who had never suffered from it. The study involved 42 people, average age 54, two-thirds men, hospitalized at San Raffaele for Covid pneumonia during the second wave of the pandemic , since fall 2020, none of whom had ever reported depression or PTSD prior to infection, nor had brain injuries during the acute phase of pneumonia. The participants in the research were followed for at least 3 months after discharge, in the clinic dedicated to follow-up at the San Raffaele Turro office. Benedetti’s team had already described persistence in previous studies, up to 3 months after discharge, of anxiety and depressive syndromes in patients recovered from severe forms of Covid-19, as well as the link between these syndromes and the level of systemic inflammation detected in the acute phase of the disease, when patients were still hospitalized. in this case, the SII, a systemic index of inflammation, was measured in the 42 patients, which assesses the intensity of the inflammatory reaction produced by the body to fight the infection by taking blood. In the months following discharge, however, in addition to the psychiatric evaluation through standardized tests, a new element was added: thanks to the technologies present at Cermac, the Center of Excellence for high-field magnetic resonance directed by Andrea Falini, head of Neuroradiology , the scientists were also able to examine functional connectivity (how different brain areas communicate with each other), white matter structure and local gray matter volume. “This is the first study of this type to investigate the psychopathological consequences of Covid-19”, highlighted by San Raffaele. “The data collected demonstrate an alteration of all 3 of these parameters – Benedetti reports – In particular, we observe a association of both gray matter volume and white matter integrity, coupled with reduced functional connectivity, with symptoms presented in long Covid and with inflammation during the acute phase of the disease. observes in patients with endogenous forms of depression, such as major depression or bipolar disorder, further demonstrating that the emergence of depressive symptoms in patients who have survived the hyper-inflammatory forms of Covid-19 should not be underestimated. It is a condition whose duration will be verified over time, and which could also explain the cognitive problems that usually accompany long Covid “. Beyond Covid-19,” it has been known for some time – rico say the experts of San Raffaele – that serious infections, such as those from influenza or viral pneumonia, may precede episodes of major depression. The causal mechanism behind this ‘trigger’ is still unclear, but the number one suspect is the immune system and in particular the inflammatory response triggered to fight the infection. Confirming this hypothesis is also the fact that depression and inflammation are closely linked: in patients with mood disorders there is often a low, but persistent level of inflammation that cannot be explained by other medical conditions “.” The Covid-19 pandemic – Benedetti comments – is allowing us to study the relationship between depression and inflammation like never before, and could help us understand more about this disease. At the same time, not only research like the one just published, but also what is already known on the relationship between infections and mood disorders, should make us keep our guard up: the severe forms of Covid-19 can have long-term consequences also from the point of view. from a psychiatric point of view. One more reason to get vaccinated and a responsibility for all of us who deal with mental health “.