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Physical symptoms and inflammatory levels characterize post-COVID-19 depressive episodes compared to

Maria Pepe1, Marco Di Nicola1, Giuseppe Mandracchia2

  • 1Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy; Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.

Journal of Affective Disorders
|May 7, 2025
PubMed

Insights

Major depressive episodes after COVID-19 often present with distinct physical and cognitive symptoms, alongside higher inflammation levels. This study differentiates these from non-COVID-19 depression, aiding targeted treatment strategies.

Area of Science:

  • Neuroscience
  • Immunology
  • Psychiatry

Background:

  • Major depressive episodes (MDE) affect approximately 30% of COVID-19 survivors.
  • A specific clinical profile of post-COVID-19 MDE, including physical, cognitive, and immune-inflammatory changes, has been suggested.
  • Direct comparisons between post-COVID-19 MDE and non-post-COVID-19 depression are limited.

Purpose of the Study:

  • To characterize and compare the physical and cognitive symptomatology and inflammatory markers in patients with post-COVID-19 MDE versus non-post-COVID-19 depression.
  • To identify specific features associated with MDE following COVID-19 infection.

Main Methods:

  • A cohort of 209 patients with MDE was assessed, categorized into post-COVID-19 and non-post-COVID-19 groups.
  • Symptomatology was evaluated using the Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HARS), Digit Symbol Substitution Test (DSST), and Perceived Deficits Questionnaire-Depression 5-items (PDQ-D5).
  • Inflammatory levels were measured using blood count-derived indexes, including the Systemic Immune-Inflammatory Index.

Main Results:

  • The post-COVID-19 MDE group (46.9%) showed higher rates of first-onset depression, older age at onset, and more pronounced physical and cognitive symptoms (HDRS, HARS, PDQ-D5 scores).
  • Elevated inflammatory indexes were significantly higher in the post-COVID-19 MDE group.
  • Logistic regression identified a significant association between post-COVID-19 MDE and physical symptomatology and the Systemic Immune-Inflammatory Index, with high discriminative potential (AUC=0.921).

Conclusions:

  • Post-COVID-19 MDE exhibits a distinct clinical presentation characterized by prominent physical symptoms and heightened systemic inflammation.
  • These findings underscore the need for precise characterization of depression following COVID-19.
  • Personalized interventions informed by specific clinical and inflammatory profiles may enhance functional recovery in affected patients.
Keywords:
COVID-19InflammationMood disordersPersonalized medicineSomatic correlates

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