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

基本信息

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
项目类别：
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

项目摘要

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.

出现了前所未有的心理健康危机，自杀念头和行为（STB）激增在大流行之前发生并因大流行而进一步加剧的年轻人中。研究表明，青少年正处于 COVID-19 感染后 1-6 个月内进行精神科诊断的事件治疗的风险增加。风险为感染者中的 STB 也有所增加； COVID-19 后的认知障碍是据报道甚至在感染后约 4 个月。除了发病率和死亡率增加之外，缓解为减少传播所做的努力给儿童和家庭带来了额外的压力（例如父母的压力）失业、父母死亡、在线教育），这些都与精神病理学发病率的增加有关在青春里。然而，我们对 COVID-19 感染对人类健康的独特贡献了解有限。青少年精神病理学的发生率以及与风险有关的生物机制。失调在免疫反应，特别是增加 IL-6、IL-1b、C 反应蛋白 (CRP) 和 TNF-a 及其 mRNA 和低皮质醇是与 COVID-19 严重程度和精神病理学有关的常见生物机制。我们的目标是研究 COVID-19 感染对青少年精神病理学发病率的影响；它的影响关于炎症和 HPA 轴标记物；并识别临床、认知、生物和心理社会这些特征将有助于预测青少年感染 COVID-19 后面临精神病理学发病风险的特征。我们拟招募12-17岁的青少年，无精神疾病或慢性病史或慢性病史感染者： 1) 在过去一个月内感染过 COVID-19（COVID，n=200）； 2) 无病史 COVID-19、流感 (IFV) 或过去 6 个月内的任何呼吸道感染（无 COVID，n=200）； 3）青年过去一个月内有 IFV（IFV，n=100）。 IFV 小组将允许我们检查是否是 COVID-19 或一般来说，感染与风险相关。参与者将在基线后 3、6 和 18 个月进行随访并评估精神和身体症状、认知功能、事件精神病理学；大流行和非流行病压力源；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轴活动测量（头发皮质醇浓度、唾液皮质醇）。我们假设新冠病毒群体将表现出相比之下，精神病理学，特别是抑郁症、焦虑症和 STB 的发病风险增加给无新冠病毒和 IVF 群体。他们还会表现出炎症增加以及精神和身体症状随着时间的推移出现症状；随着时间的推移，HPA 轴活动和认知功能降低；这些将反过来预测精神病理学的发作。这项研究将加深我们对 COVID-19 感染对人的影响的了解青少年精神病理学风险以及与风险相关的生物机制。结果也将延长其他类型的感染。这项研究对于我们为未来的流行病和疾病做好准备工作至关重要流行病不可避免，而且呈上升趋势。