Page 84 - JCBP-3-4

Journal of Clinical and
Basic Psychosomatics Psychological COVID-19 gastrointestinal

suggest that COVID-19 patients may experience delirium, In addition to morbidity and mortality, the psychological
depression, anxiety, and insomnia. Coronaviruses can impact of COVID-19 significantly affects patients’ quality
contribute to psychopathological outcomes either directly, of life. These findings underscore the need for prompt
through viral infection of the central nervous system (CNS), recognition and intervention to address the wide-ranging
or indirectly, through immune responses. There is evidence psychological consequences of the pandemic.
that coronaviruses may exhibit neurotropic properties There is mounting evidence that GI symptoms are not
and can induce neuronal injuries, as demonstrated in only prevalent in COVID-19 patients but also linked to
clinical cases, post-mortem examinations, animal models, higher stress and anxiety levels, as well as a lower quality
in vitro experiments, and cell culture studies. In addition 13
to potential CNS infiltration, the host immune response to of life. These psychological impacts are partly mediated
coronaviruses, or “cytokine storm,” may also contribute to through the gut–brain axis, a bi-directional communication
psychiatric symptoms by triggering neuroinflammation. 7 pathway between the CNS and the GI tract. In light of this
connection, investigating the mental health outcomes in
It is well-recognized that the digestive tract is one of this particular cohort was both pertinent and significant.
the systems affected by SARS-CoV-2. Recent research has
demonstrated GI symptoms, such as nausea, diarrhea, The goal of this study was to investigate the relationship
and abdominal discomfort, as common manifestations in between psychological factors and GI symptoms in
COVID-19 patients. This association is supported by the COVID-19 patients. Specifically, the study sought to
presence of ACE2 receptors in the GI epithelium, which assess the psychological impact of these symptoms in two
facilitate viral entry. While it was not the main focus of the distinct patient groups, based on medical records: One
current investigation, acknowledging the GI tract’s role group presenting with predominant GI symptoms, such
could provide a more comprehensive understanding of the as anorexia, nausea, vomiting, and abdominal pain, and
disease. Recent research also highlights the significance another group in which diarrhea was the predominant
6
of the gut-brain axis in the development of mental and symptom.
cognitive disorders. Changes in gut microbiota have been 2. Materials and methods
increasingly linked to conditions such as depression,
anxiety, schizophrenia, autism spectrum disorders, and 2.1. Materials
cognitive impairment involving memory and attention. The authors assert that all procedures contributing
Patients with COVID-19 have reported significant levels to this work comply with the ethical standards of the
of anxiety and depression symptoms. Those experiencing relevant national and institutional committees on human
social isolation exhibited higher anxiety levels. While experimentation and with the Helsinki Declaration of
these findings are noteworthy, many of the existing studies 1975, as revised in 2008. All procedures involving human
have been limited to single-point assessments and have subjects/patients were approved by the Bioethics and
not investigated the long-term mental health outcomes of Ethics Committee of AHEPA University Hospital, School
COVID-19 patients following hospital discharge. Evidence of Medicine, Aristotle University of Thessaloniki, Greece,
from previous pandemics revealed that hospitalized under the number 34191.
individuals often reported higher rates of PTSD and
increased psychological distress. 8 This study enrolled 102 COVID-19 patients and was
performed in the COVID-19 internal medicine clinics
Recent research demonstrates that COVID-19 patients, of three hospitals in central Macedonia, Greece, from
regardless of disease severity, from asymptomatic to September 2022 to December 2022. Written informed
critically ill, may present with both short- and long-term consent was obtained from all patients who agreed
neurological symptoms. The frequency and intensity of to participate in the study. Inclusion criteria included
neurological symptoms linked to COVID-19 may differ hospitalization due to COVID-19, age over 18 years,
to some extent depending on several factors, such as the a positive COVID-19 PCR test, and the presence of
extent of neuroinflammation. Furthermore, the cognitive GI symptoms, including anorexia, nausea, vomiting,
system, including executive functions and long-term abdominal pain, or diarrhea. Eligible patients experienced
memory, is most influenced by COVID-19. 7 GI symptoms for 3 – 10 days. Exclusion criteria included a
Stress, anxiety, and depression are prevalent in history of psychiatric illness, transfer to the intensive care
COVID-19 patients. According to reports, one in five unit, and inability to read or comprehend the consent form
survivors continues to experience anxiety, depression, or or testing instructions due to language barriers or limited
insomnia as late as 3 months after their initial positive educational background. A total of 102 COVID-19 patients
polymerase chain reaction (PCR) test for COVID-19. 13,14 who presented with GI symptoms were enrolled in

Volume 3 Issue 4 (2025) 78 doi: 10.36922/JCBP025040007