Elevated C-reactive protein and depression score among post-COVID-19 patients - A cross-sectional study

Abstract

Abstract Immune dysfunction after SARS-CoV-2 infection leads to long COVID neurological sequels in COVID-19 survivors. Despite initial respiratory symptoms, neuropsychiatric manifestations have been reported in many COVID-19 patients. We aimed to investigate the psychological symptoms, gut microbiome status, and C-reactive protein levels (CRP) in post-COVID individuals. This cross-sectional study included age and sex-matched individuals with post-COVID (n = 114) or controls (n = 236). We used Mini International Neuropsychiatric Interview (MINI) to diagnose psychiatric disorders. The depressive and anxiety symptoms were assessed by the Hamilton Rating Scale and the stress level by an inventory of stress symptoms and circulating CRP levels measured. In a small cohort (post-COVID = 18 and controls = 46), the gut microbiome was evaluated by 16S rRNA sequencing. Post-COVID individuals exhibited greater severity of depressive symptoms (p = 0.034), higher levels of stress (p = 0.020), and CRP (p = 0.014) as compared to controls. There was no difference in α-diversity but β-diversity (p = 0.001) was significantly different between control and post-COVID groups. Interestingly, post-COVID individuals with depression had greater CRP levels than those with COVID-19 without current major depression disorder (p = 0.023). Post-COVID-19 individuals have demonstrated severe psychological symptoms and altered gut microbiome levels. Although longitudinal studies are needed to study the mental health trajectory of COVID-19 individuals, the levels of CRP may serve as a promising biomarker for the early detection of post-COVID depression.