Abstract:
Background: Serotonin has been suggested to be a possible mediator in the pathophysiology of COVID-19, linking the pulmonary, intestinal, cardiac, neurological, and psychiatric manifestations of severe COVID-19 in people with diabetes and obesity. On the other hand, psychosocial stress, loss of physical capacity, and the presence of neurocognitive symptoms have been found to worsen mental health and reduce the quality of life (QoL) in individuals after COVID-19. The aim of the study was to investigate the associations between the level of serotonin and the degree of cognitive and psycho-emotional disorders in patients in the post-covid period, depending on their metabolic phenotype.
Methods: 45 patients who underwent COVID-19 pneumonia with oxygen therapy and corticosteroids were examined. Patients were divided into 2 groups: the first group (10 men and 10 women, 40±17 years old) had normal serotonin levels and normal body weight, the second group (17 men and 7 women, 53±14 years old) - low serotonin level and presence of obesity. The following tests were carried out: hematological, biochemical parameters, the levels of CRP, D-dimer and serotonin. The quality of life parameters of the patients were studied by the questionnaire method 6 months after recovery using the WHOQOL-BREF 2022 questionnaires, the psycho-emotional state was assessed according to The Hospital Anxiety and Depression Scale, and The General Practitioner Assessment of Cognition was used for cognitive function.
Results: There were no significant differences in the values of neurocognitive and social parameters in the post-covid period depending on the initial level of serotonin. Quality of life scores in group 1 were positively correlated with cognition (r from 0.54 to 0.73; P<0.05) and negatively with anxiety and depression (r from -0.60 to -0.80; P<0, 05). In the 2nd group, the level of serotonin was positively associated with self-assessments of the quality of life (r from 0.42 to 0.53; P<0.05) and negatively - with cognition and anxiety (r from -0.51 to -0 .60; P<0.05).
Conclusions: Obese patients may have prognostically worse quality of life and cognitive function after experiencing COVID-19 due to decreased serotonin levels during the acute phase of the disease.
