Psychiatric symptoms in covid-19 inpatients and 2-month follow-up: an exploration of the relationship with neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and D-dimer

Aim: COVID-19 is linked to mental health challenges. In this study, we assessed anxiety, depression, sleep quality, and their correlation with inflammatory markers in COVID-19 inpatients. Material and Methods: In this prospective clinical study, COVID-19 inpatients evaluated twice, 2 months apart. During the initial evaluation, participants completed the Sociodemographic Data Form, Hospital Anxiety and Depression Scale (HADS), and Pittsburgh Sleep Quality Index (PSQI). Additionally, relevant clinical information and laboratory results were extracted from the hospital automation system. In the second assessment, HADS and PSQI were again administered. Results: In the psychiatric diagnosis group (In the group with a past psychiatric diagnosis such as depression, anxiety disorders and sleep disorders) (n=26), platelet (PLT) and platelet-to-lymphocyte ratio (PLR) values were significantly higher than in others (z= -2.090, p=0.037; z=-2.561, p=0.010). Patients' HADS-Anxiety scores positively correlated with PSQI scores (r = 0.230, p = 0.015). HADS-Anxiety (p = 0.853), HADS-Depression (p = 0.562), and PSQI (p = 0.737) scores showed no significant change from the initial evaluation at the 2nd-month endpoint. Hospitalization duration correlated positively with neutrophil- to-lymphocyte ratio NLR (p = 0.016, r = 0.229), PLR (p = 0.008, r = 0.251), Ferritin (p < 0.001, r = 0.368), D-Dimer (p = 0.003, r = 0.285), and CRP values (p < 0.001, r = 0.330), while negatively with lymphocyte count (p = 0.004, r = -0.273). Conclusion: This study underscores the importance of monitoring psychiatric symptoms, such as anxiety, depression and sleep problems, during COVID-19 process and its relation with inflammatory parameters. The results addresses the controversy surrounding psychological symptoms linked to inflammation, and may contribute to the literature.