The Role of Anxiety and Cortisol in Outcomes of Patients With Covid-19

Mahtab Ramezani; Leila Simani; Ehsan Karimialavijeh; Omidvar Rezaei; Mohammadreza Hajiesmaeili; Hossein Pakdaman

doi:10.32598/bcn.11.covid19.1168.2

The Role of Anxiety and Cortisol in Outcomes of Patients With Covid-19

Basic Clin Neurosci. 2020 Mar-Apr;11(2):179-184. doi: 10.32598/bcn.11.covid19.1168.2. Epub 2020 Apr 13.

Authors

Mahtab Ramezani¹, Leila Simani¹, Ehsan Karimialavijeh², Omidvar Rezaei¹, Mohammadreza Hajiesmaeili³, Hossein Pakdaman⁴

Affiliations

¹ Skull-Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
² Department of Emergency Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
³ Anesthesiology Research Center, Loghman Hakim Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
⁴ Brain Mapping Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Abstract

Introduction: The outbreak due to Coronavirus Disease 2019 (COVID-19) is n global public health emergency and challenges psychological resilience. The central nervous system, endocrine system, and immune system are complex interacting systems. Cortisol has been implicated as the cause of a wide range of mental and physical health disorders; however, the impact of cortisol on outcomes in patients with COVID-19 is not clear.

Methods: The current study enrolled patients with COVID-19 (onset of disease within 7 days of the first symptom) to evaluate the serum concentration of cortisol and levels of anxiety and depression using the Hospital Anxiety and Depression Scale (HADS) to investigate a possible relationship between cortisol, depression, and anxiety levels and outcomes of patients with COVID-19.

Results: A total of 30 patients with COVID-19 were studied. The levels of cortisol and HADS score in patients who died of Covid-19 were significantly higher in comparison with surviving patients (P<0.017 and P<0.001 respectively). We also found that the HADS score was positively correlated with serum cortisol levels (r= 0.842, P=0.004).

Conclusion: Our findings showed that stress and anxiety are associated with patients' outcomes. Psychological interventions can improve the mental health of vulnerable groups during the COVID-19 epidemic.

Keywords: Anxiety; COVID-19; Cortisol; Stress.