The effect of dual inflammation on the acute phase clinical outcomes of schizophrenia patients with comorbid COVID-19

Background and hypothesis: Inflammation plays a crucial role in pathological mechanisms in schizophrenia (SZ) and the coronavirus disease 2019 (COVID-19), but the impact of dual inflammation on SZs’ clinical outcomes is poorly understood. This study aimed to investigate whether dual inflammation imp...

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Main Authors: Jiahui Zhu, Jiamin Shao, Peng Wang, Yuan Liu, Gangming Cheng, Qi Zhou, Zhuoran Li, Jiayi Li, Mingqia Wang, Zhuokai Zhang, Xuan Dong, Chuan Shi
Format: Article
Language:English
Published: Elsevier 2025-07-01
Series:Brain, Behavior, & Immunity - Health
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666354625000730
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author Jiahui Zhu
Jiamin Shao
Peng Wang
Yuan Liu
Gangming Cheng
Qi Zhou
Zhuoran Li
Jiayi Li
Mingqia Wang
Zhuokai Zhang
Xuan Dong
Chuan Shi
author_facet Jiahui Zhu
Jiamin Shao
Peng Wang
Yuan Liu
Gangming Cheng
Qi Zhou
Zhuoran Li
Jiayi Li
Mingqia Wang
Zhuokai Zhang
Xuan Dong
Chuan Shi
author_sort Jiahui Zhu
collection DOAJ
description Background and hypothesis: Inflammation plays a crucial role in pathological mechanisms in schizophrenia (SZ) and the coronavirus disease 2019 (COVID-19), but the impact of dual inflammation on SZs’ clinical outcomes is poorly understood. This study aimed to investigate whether dual inflammation impacts acute phase outcomes in patients with schizophrenia comorbid with COVID-19 (COVID-SZs). Study design: A total of 114 SZs and 49 COVID-SZs were recruited for this study. Plasma samples were collected and analyzed for levels of routine blood and inflammatory cytokines from all the participants. Then clinical symptoms, cognitive performance, and functional assessments were conducted at recruitment. One-way analysis of covariance examined the differences in inflammatory cytokines and correlation analyses examined the relationship between inflammatory cytokines and clinical outcomes. Study results: After controlling for age, gender, substance use status, and antipsychotic medications, levels of inflammatory cytokines increased in COVID-SZs groups compared to SZs groups. There were significantly higher total Positive and Negative Syndrome Scale (PANSS) scores and positive PANSS scores in COVID-SZs groups compared to SZs. As for cognitive performance, the COVID-SZs group had significantly worse performance in processing speed and attention than the SZs. The COVID-SZs group had significantly worse health status compared to the SZs. There were significantly different correlation patterns between the severity of psychiatric symptoms and inflammatory cytokines in COVID-SZs and SZs group. Conclusions: Findings indicate that dual inflammation exacerbates the acute phase clinical outcome of COVID-SZs. Suggesting a combined anti-inflammatory drug or the use of potentially anti-inflammatory antipsychotics in the acute phase of treatment to mitigate central nervous system damage. Regular monitoring of inflammatory marker levels can help reduce the risk of fluctuating psychiatric symptoms in patients with schizophrenia caused by inflammatory storms.
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spelling doaj-art-52f2b5814f344901a84c3828ff28b5b02025-08-20T03:21:15ZengElsevierBrain, Behavior, & Immunity - Health2666-35462025-07-014610101510.1016/j.bbih.2025.101015The effect of dual inflammation on the acute phase clinical outcomes of schizophrenia patients with comorbid COVID-19Jiahui Zhu0Jiamin Shao1Peng Wang2Yuan Liu3Gangming Cheng4Qi Zhou5Zhuoran Li6Jiayi Li7Mingqia Wang8Zhuokai Zhang9Xuan Dong10Chuan Shi11Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, ChinaPeking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, ChinaWuhan Mental Health Center, Department of Psychiatry, Wuhan Hospital for Psychotherapy, Wuhan, ChinaThe Eighth Clinical College Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaWuhan Mental Health Center, Department of Psychiatry, Wuhan Hospital for Psychotherapy, Wuhan, ChinaThe Affiliated Brain Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Applied Psychology and Human Development, University of Toronto, CanadaPeking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, ChinaPeking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, ChinaPeking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, ChinaThe Eighth Clinical College Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Corresponding author. The Eighth Clinical College Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430023, China.Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China; Corresponding author. Peking University Sixth Hospital, 51 Huayuanbei Road, Haidian District, Beijing, 100191, China.Background and hypothesis: Inflammation plays a crucial role in pathological mechanisms in schizophrenia (SZ) and the coronavirus disease 2019 (COVID-19), but the impact of dual inflammation on SZs’ clinical outcomes is poorly understood. This study aimed to investigate whether dual inflammation impacts acute phase outcomes in patients with schizophrenia comorbid with COVID-19 (COVID-SZs). Study design: A total of 114 SZs and 49 COVID-SZs were recruited for this study. Plasma samples were collected and analyzed for levels of routine blood and inflammatory cytokines from all the participants. Then clinical symptoms, cognitive performance, and functional assessments were conducted at recruitment. One-way analysis of covariance examined the differences in inflammatory cytokines and correlation analyses examined the relationship between inflammatory cytokines and clinical outcomes. Study results: After controlling for age, gender, substance use status, and antipsychotic medications, levels of inflammatory cytokines increased in COVID-SZs groups compared to SZs groups. There were significantly higher total Positive and Negative Syndrome Scale (PANSS) scores and positive PANSS scores in COVID-SZs groups compared to SZs. As for cognitive performance, the COVID-SZs group had significantly worse performance in processing speed and attention than the SZs. The COVID-SZs group had significantly worse health status compared to the SZs. There were significantly different correlation patterns between the severity of psychiatric symptoms and inflammatory cytokines in COVID-SZs and SZs group. Conclusions: Findings indicate that dual inflammation exacerbates the acute phase clinical outcome of COVID-SZs. Suggesting a combined anti-inflammatory drug or the use of potentially anti-inflammatory antipsychotics in the acute phase of treatment to mitigate central nervous system damage. Regular monitoring of inflammatory marker levels can help reduce the risk of fluctuating psychiatric symptoms in patients with schizophrenia caused by inflammatory storms.http://www.sciencedirect.com/science/article/pii/S2666354625000730SchizophreniaCOVID-19Dual inflammationClinical outcomesInflammatory cytokines
spellingShingle Jiahui Zhu
Jiamin Shao
Peng Wang
Yuan Liu
Gangming Cheng
Qi Zhou
Zhuoran Li
Jiayi Li
Mingqia Wang
Zhuokai Zhang
Xuan Dong
Chuan Shi
The effect of dual inflammation on the acute phase clinical outcomes of schizophrenia patients with comorbid COVID-19
Brain, Behavior, & Immunity - Health
Schizophrenia
COVID-19
Dual inflammation
Clinical outcomes
Inflammatory cytokines
title The effect of dual inflammation on the acute phase clinical outcomes of schizophrenia patients with comorbid COVID-19
title_full The effect of dual inflammation on the acute phase clinical outcomes of schizophrenia patients with comorbid COVID-19
title_fullStr The effect of dual inflammation on the acute phase clinical outcomes of schizophrenia patients with comorbid COVID-19
title_full_unstemmed The effect of dual inflammation on the acute phase clinical outcomes of schizophrenia patients with comorbid COVID-19
title_short The effect of dual inflammation on the acute phase clinical outcomes of schizophrenia patients with comorbid COVID-19
title_sort effect of dual inflammation on the acute phase clinical outcomes of schizophrenia patients with comorbid covid 19
topic Schizophrenia
COVID-19
Dual inflammation
Clinical outcomes
Inflammatory cytokines
url http://www.sciencedirect.com/science/article/pii/S2666354625000730
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