1
|
Kucukkarapinar M, Yay-Pence A, Yildiz Y, Buyukkoruk M, Yaz-Aydin G, Deveci-Bulut TS, Gulbahar O, Senol E, Candansayar S. Psychological outcomes of COVID-19 survivors at sixth months after diagnose: the role of kynurenine pathway metabolites in depression, anxiety, and stress. J Neural Transm (Vienna) 2022; 129:1077-1089. [PMID: 35796878 PMCID: PMC9261222 DOI: 10.1007/s00702-022-02525-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 06/20/2022] [Indexed: 10/31/2022]
Abstract
Coronavirus disease 2019 (COVID-19) has resulted in long-term psychiatric symptoms because of the immunologic response to the virus itself as well as fundamental life changes related to the pandemic. This immune response leads to altered tryptophan (TRP)-kynurenine (KYN) pathway (TKP) metabolism, which plays an essential role in the pathophysiology of mental illnesses. We aimed to define TKP changes as a potential underlying mechanism of psychiatric disorders in post-COVID-19 patients. We measured plasma levels of several TKP markers, including KYN, TRP, kynurenic acid (KYNA), 3-hydroxykynurenine (3-HK), and quinolinic acid (QUIN), as well as the TRP/KYN, KYNA/3-HK, and KYNA/QUIN ratios, in 90 post-COVID-19 patients (on the first day of hospitalization) and 59 healthy controls (on the first admission to the Check-Up Center). An online questionnaire that included the Depression, Anxiety and Stress Scale-21 (DASS-21) was used 6 months after the initial assessment in both groups. A total of 32.2% of participants with COVID-19 showed depressive symptoms, 21.1% exhibited anxiety, and 33.3% had signs of stress at follow-up, while 6.6% of healthy controls exhibited depressive and anxiety symptoms and 18.6% had signs of stress. TRP and 3-HK were negative predictors of anxiety and stress, but KYN positively predicted anxiety and stress. Moreover, TRP negatively predicted depression, while KYNA/3-HK was a negative predictor of anxiety. The correlation between depression, anxiety, and stress and TKP activation in COVID-19 could provide prospective biomarkers, especially the reduction in TRP and 3HK levels and the increase in KYN. Our results suggest that the alteration of TKP is not only a potential biomarker of viral infection-related long-term psychiatric disorders but also that the therapy targets future viral infections related to depression and anxiety.
Collapse
Affiliation(s)
- Melike Kucukkarapinar
- Psychiatry Department, Faculty of Medicine, Gazi University, Emniyet Mah., Yenimahalle, 06560, Ankara, Turkey.
| | - Aysegul Yay-Pence
- Psychiatry Department, Faculty of Medicine, Gazi University, Emniyet Mah., Yenimahalle, 06560, Ankara, Turkey
| | - Yesim Yildiz
- Department of Infectious Diseases, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Merve Buyukkoruk
- Department of Infectious Diseases, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Gizem Yaz-Aydin
- Department of Medical Biochemistry, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Tuba S Deveci-Bulut
- Department of Medical Biochemistry, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Ozlem Gulbahar
- Department of Medical Biochemistry, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Esin Senol
- Department of Infectious Diseases, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Selcuk Candansayar
- Psychiatry Department, Faculty of Medicine, Gazi University, Emniyet Mah., Yenimahalle, 06560, Ankara, Turkey
| |
Collapse
|