Dysregulated inflammation may predispose patients with serious mental illnesses to severe COVID‑19 (Review)
Sergej Nadalin1, Hrvoje Jakovac2, Vjekoslav Peitl3
1Department of Medical Biology and Genetics, Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia.
Insights
This review explores how inflammation, diet, smoking, and ACE gene variations link severe COVID-19 to serious mental illness (SMI). ACE inhibitors may offer protective benefits for both conditions.
Area of Science:
- Neuroscience
- Immunology
- Genetics
Background:
- Inflammation may link severe COVID-19 and serious mental illness (SMI).
- Systematic assessment of inflammatory factors influencing COVID-19 outcomes in SMI is lacking.
Purpose of the Study:
- To review extrinsic (diet, smoking, psychotropic drugs) and intrinsic (ACE I/D gene polymorphism) risk factors for SMI and COVID-19.
- To propose a genetics-based prediction model for SMI in severe COVID-19 patients.
- To explore the potential protective role of ACE inhibitors.
Main Methods:
- Literature review of genetic and non-genetic factors.
- Discussion of extrinsic risk factors: dietary patterns, smoking, psychotropic medications.
- Consideration of intrinsic risk factors: angiotensin-converting enzyme (ACE) insertion/deletion (I/D) gene polymorphisms.
Main Results:
- Diet, smoking, and ACE I/D gene polymorphisms are potential risk factors for SMI and severe COVID-19.
- ACE inhibitors may have protective effects against SMI and severe COVID-19, especially in patients with cardiovascular comorbidities.
Conclusions:
- Inflammatory response-related factors, including genetic predispositions and lifestyle choices, are crucial in understanding the link between severe COVID-19 and SMI.
- ACE inhibitors represent a potential therapeutic strategy for improving outcomes in severe COVID-19 patients with or at risk of SMI.
Abstract:
Genetic and nongenetic factors associated with an increased inflammatory response may mediate a link between severe coronavirus disease 2019 (COVID‑19) and serious mental illness (SMI). However, systematic assessment of inflammatory response‑related factors associated with SMI that could influence COVID‑19 outcomes is lacking. In the present review, dietary patterns, smoking and the use of psychotropic medications are discussed as potential extrinsic risk factors and angiotensin‑converting enzyme (ACE) insertion/deletion (I/D) gene polymorphisms are considered as potential intrinsic risk factors. A genetics‑based prediction model for SMI using ACE‑I/D genotyping is also proposed for use in patients experiencing severe COVID‑19. Furthermore, the literature suggests that ACE inhibitors may have protective effects against SMI or severe COVID‑19, which is often linked to hypertension and other cardiovascular comorbidities. For this reason, we hypothesize that using these medications to treat patients with severe COVID‑19 might yield improved outcomes, including in the context of SMI associated with COVID‑19.
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