COVID-19, Inflammation and HPA axis activity, and Risk for Psychopathology in Youth

COVID-19、炎症和 HPA 轴活动以及青少年精神病理学风险

• 批准号: 10753189
• 负责人: Nadine M. Melhem
• 金额: $ 79.48万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-01 至 2028-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10753189
• 关键词: Acute; Adolescent; Adult; Age; Antibodies; Anxiety Disorders; Biological; Biological Markers; Blood; C-reactive protein; COVID-19; COVID-19 impact; COVID-19 pandemic; COVID-19 severity; Cessation of life; Characteristics; Child; Chronic; Chronic Disease; Clinical; Cognitive; Data; Development; Domestic Violence; Emerging Communicable Diseases; Family; Family history of; Feeling suicidal; Frequencies; Genes; Goals; Hair; Hydrocortisone; Immune response; Impaired cognition; Incidence; Individual; Infection; Inflammation; Inflammatory; Influenza; Interleukin-6; Intervention; Job loss; Measures; Mental Depression; Mental Health; Mental disorders; Messenger RNA; Monitor; Morbidity - disease rate; Participant; Psychiatric Diagnosis; Psychiatric therapeutic procedure; Psychopathology; Public Health; Race; Readiness; Recording of previous events; Reporting; Respiratory Tract Infections; Risk; Risk Factors; SARS-CoV-2 infection; Salivary; Schools; Severities; Socioeconomic Status; TNF gene; Testing; Time; Vaccination; Youth; aged; chronic infection; cognitive function; coronavirus disease; cytokine; future epidemic; future pandemic; high risk; hypothalamic-pituitary-adrenal axis; improved; mortality; novel therapeutic intervention; pandemic disease; pandemic impact; physical symptom; post SARS-CoV-2 infection; protective factors; psychiatric symptom; psychosocial; recruit; sex; stressor; suicidal behavior; suicidal risk; transmission process

There has been an unprecedented mental health crisis and a surge in suicidal thoughts and behaviors (STBs) among youth that predated and was further exacerbated by the pandemic. Studies show that youth are at increased risk for incident treatment for psychiatric diagnosis 1-6 months following COVID-19 infection. Risk for STBs is also increased among individuals with infections; and cognitive impairment following COVID-19 is reported even ~4 months following infection. In addition to the increased morbidity and mortality, the mitigation efforts put in place to reduce transmission resulted in additional stressors on children and families (e.g., parental job loss, parental death, online schooling) and these were associated with increased rates of psychopathology in youth. However, we have a limited understanding of the unique contribution of COVID-19 infection on incidence of psychopathology in youth and the biological mechanisms implicated in risk. Dysregulations in immune responses, specifically, increased IL-6, IL-1b, C-Reactive Protein (CRP), and TNF-a and their mRNA and low cortisol are common biological mechanisms implicated in COVID-19 severity and in psychopathology. Our goals are to examine the impact of COVID-19 infection on incidence of psychopathology in youth; its impact on inflammation and HPA axis markers; and to identify clinical, cognitive, biological, and psychosocial characteristics that will help predict youth at risk for onset of psychopathology following COVID-19 infection. We propose to recruit youth, aged 12-17 years, without history of psychiatric disorders or chronic Illness or chronic infections who were: 1) infected with COVID-19 within the past month (COVID, n=200); 2) without history of COVID-19, influenza (IFV), or any respiratory infections in the past 6 months (no-COVID, n=200); and 3) youth with IFV within the past month (IFV, n=100). The IFV group will allow us to examine whether COVID-19 or infections in general are associated with risk. Participants will be followed at 3, 6, and 18 months after baseline and assessed on psychiatric and physical symptoms, cognitive function, incident psychopathology; pandemic and non-pandemic stressors; and risk and protective factors at all timepoints. At baseline, 3, and 6 months, we will measure inflammation (cytokines, mRNA for inflammatory genes); and collect acute and chronic HPA axis activity measures (hair cortisol concentrations, salivary cortisol). We hypothesize that the COVID group will show increased risk of onset of psychopathology, specifically depression and anxiety disorders and STBs, compared to the no-COVID and IVF groups. They will also show increased inflammation and psychiatric and physical symptoms over time; and reduced HPA axis activity and cognitive function over time; and these will in turn predict onset of psychopathology. This study will advance our understanding of the impact of COVID-19 infection on risk for psychopathology in youth and the biological mechanisms implicated in risk. The results will also extend to other types of infections. This study is essential to inform our preparedness efforts for future epidemics and pandemics, which are inevitable and on the rise.

存在前所未有的心理健康危机和自杀思想和行为的激增（STB） 在早期并进一步加剧了大流行的年轻人中。研究表明，青年在 在COVID-19感染后1-6个月，患有精神诊断事件治疗的风险增加。风险 感染患者之间的STB也有所增加；与19 covid-19之后的认知障碍是 感染后甚至报告了约4个月。除了发病率和死亡率的增加外，缓解措施 为减少传播而做出的努力导致儿童和家庭的其他压力（例如，父母 失业，父母死亡，在线教育），这些与精神病理学率提高有关 在青年时期。但是，我们对COVID-19感染对独特贡献的独特贡献有限 青年心理病理学的发病率以及与风险有关的生物学机制。失调 免疫反应，具体来说，IL-6，IL-1B，C反应蛋白（CRP）和TNF-A及其mRNA 低皮质醇和低皮质醇是涉及共证的严重程度和心理病理学的常见生物学机制。 我们的目标是研究COVID-19-19的影响对年轻人心理病理学的发病率的影响；它的影响 关于炎症和HPA轴标记；并确定临床，认知，生物学和社会心理 特征将有助于预测Covid-19感染后心理病理学风险的年轻人。我们 提议招募12-17岁的青年，没有精神病史或慢性病或慢性 过去一个月内感染了Covid-19的感染：1）感染了Covid-19（Covid，n = 200）； 2）没有历史 在过去6个月中，Covid-19，流感（IFV）或任何呼吸道感染（Nocovid，n = 200）； 3）青年 在过去一个月内使用IFV（IFV，n = 100）。 IFV组将允许我们检查COVID-19或 通常，感染与风险有关。参与者将在基线后3、6和18个月遵循 并评估精神病和身体症状，认知功能，事件心理病理学；大流行 和非大流行压力源；以及所有时间点的风险和保护因素。在基线，3个月和6个月时，我们 将测量炎症（细胞因子，炎症基因的mRNA）；并收集急性和慢性HPA轴 活性度量（皮质醇浓度，唾液皮质醇）。我们假设Covid组将显示 相比 到无循环和IVF组。他们还将表现出炎症，精神病和身体的增加 随着时间的流逝症状；随着时间的流逝，HPA轴活动和认知功能降低；这些反过来会预测 心理病理学的发作。这项研究将提高我们对Covid-19感染对的影响 青年人心理病理学的风险以及与风险有关的生物学机制。结果也将扩展 到其他类型的感染。这项研究对于告知我们为未来流行病和 大流行病是不可避免的，并且正在上升。