Cited by 526Long-Term Effects of COVID-19COVID-19 and Mental HealthCOVID-19 Clinical Research Studies

The DOI matches its Crossref record; 75 of the 78 references it cites were found in a registry or an index; none of the 65 sources its claims cite is checked for support yet.

Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: Effect of inflammatory biomarkers at three-month follow-up

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Mazza, Mario Gennaro, Palladini, Mariagrazia, De Lorenzo, Rebecca, Magnaghi, Cristiano, Poletti, Sara, Furlan, Roberto, Ciceri, Fabio, Rovere-Querini, Patrizia, Benedetti, Francesco·2021·Brain, Behavior, and Immunity

DOI 10.1016/j.bbi.2021.02.021PMC PMC7903920

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Abstract

COVID-19 outbreak is associated with mental health implications during viral infection and at short-term follow-up. Data on psychiatric and cognitive sequelae at medium-term follow-up are still lacking. During an ongoing prospective cohort study, the psychopathological and cognitive status of 226 COVID-19 pneumonia survivors (149 male, mean age 58) were prospectively evaluated one and three months after hospital discharge. Psychiatric clinical interview, self-report questionnaires, and neuropsychological profiling of verbal memory, working memory, psychomotor coordination, executive functions, attention and information processing, and verbal fluency were performed. Three months after discharge from the hospital, 35.8% still self-rated symptoms in the clinical range in at least one psychopathological dimension. We observed persistent depressive symptomatology, while PTSD, anxiety, and insomnia decreased during follow-up. Sex, previous psychiatric history, and the presence of depression at one month affected the depressive symptomatology at three months. Regardless of clinical physical severity, 78% of the sample showed poor performances in at least one cognitive domain, with executive functions and psychomotor coordination being impaired in 50% and 57% of the sample. Baseline systemic immune-inflammation index (SII), which reflects the immune response and systemic inflammation based on peripheral lymphocyte, neutrophil, and platelet counts, predicted self-rated depressive symptomatology and cognitive impairment at three-months follow-up; and changes of SII predicted changes of depression during follow-up. Neurocognitive impairments associated with severity of depressive psychopathology, and processing speed, verbal memory and fluency, and psychomotor coordination were predicted by baseline SII. We hypothesize that COVID-19 could result in prolonged systemic inflammation that predisposes patients to persistent depression and associated neurocognitive dysfunction. The linkage between inflammation, depression, and neurocognition in patients with COVID-19 should be investigated in long-term longitudinal studies, to better personalize treatment options for COVID-19 survivors.

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Crossref · 10.1016/j.bbi.2021.02.021

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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We observed persistent depressive symptomatology, while PTSD, anxiety, and insomnia decreased during follow-up.”
- Also stated in: § Psychopathology and need for treatment · plain
  “From the one-month to the three-month follow-up, patients showed a significant decrease over time of PTSD symptoms (IES-R: F = 21.29, p = 0.001; PCL-5: F = 9.07, p = 0.003), anxiety (STAI-state: F = 11.28, p = 0.001), and insomnia (WHIIRS: F = 9.36, p = 0.003), irrespectively of sex and previous psychiatric history”
§ Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: Effect of inflammatory biomarkers at three-month follow-up > Abstract
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We observed persistent depressive symptomatology, while PTSD, anxiety, and insomnia decreased during follow-up.”
- Also stated in: § Psychopathology and need for treatment · plain
  “From the one-month to the three-month follow-up, patients showed a significant decrease over time of PTSD symptoms (IES-R: F = 21.29, p = 0.001; PCL-5: F = 9.07, p = 0.003)”
§ Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: Effect of inflammatory biomarkers at three-month follow-up > Abstract
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We observed persistent depressive symptomatology, while PTSD, anxiety, and insomnia decreased during follow-up.”
- Also stated in: § Psychopathology and need for treatment · plain
  “From the one-month to the three-month follow-up, patients showed a significant decrease over time of PTSD symptoms (IES-R: F = 21.29, p = 0.001; PCL-5: F = 9.07, p = 0.003), anxiety (STAI-state: F = 11.28, p = 0.001), and insomnia (WHIIRS: F = 9.36, p = 0.003), irrespectively of sex and previous psychiatric history”
§ Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: Effect of inflammatory biomarkers at three-month follow-up > Abstract
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Three months after discharge from the hospital, 35.8% still self-rated symptoms in the clinical range in at least one psychopathological dimension.”
- Also stated in: § Psychopathology and need for treatment · plain
  “Three months after hospital discharge 81/226 patients (35.8%) self-rated symptoms in the clinical range in at least one psychopathological dimension”
§ Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: Effect of inflammatory biomarkers at three-month follow-up > Abstract
Load-bearingStrength:plain· not yet calibratedn = 226
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes

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Probably not a substantial claim. 33

A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Sex, previous psychiatric history, and the presence of depression at one month affected the depressive symptomatology at three months.”
- Also stated in: § Psychopathology and need for treatment · plain
  “in patients with previous lifetime psychiatric history (ZSDS: β = 0.15, F = 4.66, p = 0.32; BDI-13: β = 0.23, F = 10.65, p = 0.001)”
§ Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: Effect of inflammatory biomarkers at three-month follow-up > Abstract
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In the paper
“we observed that females, patients with positive psychiatric history, patients with shorter hospitalization, and patients who presented psychopathology at one-month follow-up showed higher depressive symptomatology (Mazza et al., 2020)”
§ Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: Effect of inflammatory biomarkers at three-month follow-up > Discussion
What the sources say
- Not checked yetcites Mazza et al., 2020 source
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It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Validated self-report questionnaires were used to assess psychopathology: Impact of Event Scale - Revised (IES-R) (Creamer et al., 2003), PTSD Checklist for DSM-5 (PCL-5) (Armour et al., 2016), Zung Self-Rating Depression Scale (ZSDS) (Zung, 1965), 13-item Beck’s Depression Inventory (BDI-13) (Beck and Steer, 1984), State-Trait Anxiety Inventory form Y (STAI-Y) (Vigneau and Cormier, 2008), Women’s”
§ Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: Effect of inflammatory biomarkers at three-month follow-up > Material and methods > Clinical and neuropsychological assessment
What the sources say
- Not checked yetcites Creamer et al., 2003 source
- Not checked yetcites Armour et al., 2016 source
- Not checked yetcites Zung, 1965 source
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Probably not a substantial claim.
In the paper
“Considering that domain scores were adjusted according to normative Italian scores for the BACS subtests in patients aged 18–70 years, we did not perform cognitive assessment in patients older than 70 years (Anselmetti et al., 2008).”
§ Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: Effect of inflammatory biomarkers at three-month follow-up > Material and methods > Clinical and neuropsychological assessment
What the sources say
- Not checked yetcites Anselmetti et al., 2008 source
Strength:plain· not yet calibratedn = 130
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Emerging data show that COVID-19 outbreak is associated with delirium, fatigue, confusion, depression, anxiety, post-traumatic stress disorder (PTSD), obsessive–compulsive symptoms, and insomnia in the context of acute viral infection or at short-term follow-up after clinical recovery”
§ Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: Effect of inflammatory biomarkers at three-month follow-up > Introduction
What the sources say
- Not checked yetcites De Lorenzo et al., 2020 source
- Not checked yetcites Ma et al., 2020
- Not checked yetcites Mazza et al., 2020 source
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It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The host immune response to SARS-CoV-2 infection, the persistent psychological stress before and during infection (Korman et al., 2020, Vai et al., 2020), and a possible direct viral infections of the central nervous system represent possible mechanisms to induce neuropsychiatric sequelae (Troyer et al., 2020).”
§ Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: Effect of inflammatory biomarkers at three-month follow-up > Introduction
What the sources say
- Not checked yetcites Korman et al., 2020 source
- Not checked yetcites Vai et al., 2020
- Not checked yetcites Troyer et al., 2020 source
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In the paper
“T helper (Th)-1 cytokines, including Interleukin (IL)-1β, IL-6, Interferon (IFN)-γ, Tumor Necrosis Factor (TNF)-α, CXCL10, and CCL2; and Th-2 cytokines, including IL-4, IL-10, and IL-1 receptor antagonist are all elevated in the serum of COVID-19 patients (Coperchini et al., 2020) in a “cytokine storm” typically associated with the illness.”
§ Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: Effect of inflammatory biomarkers at three-month follow-up > Introduction
What the sources say
- Not checked yetcites Coperchini et al., 2020 source
Load-bearingStrength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
Probably not a substantial claim.
In the paper
“Peripheral cytokines involved in the host anti-viral response may elicit psychiatric symptoms by precipitating inflammation in the periphery and in central nervous system (CNS) (Dantzer, 2018).”
§ Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: Effect of inflammatory biomarkers at three-month follow-up > Introduction
What the sources say
- Not checked yetcites Dantzer, 2018 source
Load-bearingStrength:hedged· not yet calibratedCausal:conditional· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
Probably not a substantial claim.
In the paper
“Moreover, significant stressors such as fear of severe and unknown disease, loneliness, stigma, and the denial contribute to widespread emotional distress and increased risk for psychiatric illness in COVID-19 patients (Pfefferbaum and North, 2020).”
§ Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: Effect of inflammatory biomarkers at three-month follow-up > Introduction
What the sources say
- Not checked yetcites Pfefferbaum and North, 2020 source
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Higher immune/inflammatory setpoints with higher circulating biomarkers of inflammation are observed in mood disorders in the absence of known triggering factors, and are currently investigated as underpinning pathogenetic mechanisms for depressive psychopathology (Gibney and Drexhage, 2013, Grosse et al., 2015, Poletti et al., 2020b).”
§ Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: Effect of inflammatory biomarkers at three-month follow-up > Introduction
What the sources say
- Not checked yetcites Gibney and Drexhage, 2013
- Not checked yetcites Grosse et al., 2015 source
- Not checked yetcites Poletti et al., 2020b
Load-bearingStrength:plain· not yet calibratedCausal:correlational· not yet calibrated
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Probably not a substantial claim. It may state two separate claims as one.
In the paper
“The quality of the statistical model was checked using the entropy maximization principle of the Akaike information criterion (AIC) (Akaike, 1974).”
§ Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: Effect of inflammatory biomarkers at three-month follow-up > Material and methods > Statistical analyses
What the sources say
- Not checked yetcites Akaike, 1974 source
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“This finding is consistent with the reported higher depression in convalescent COVID-19 patients with higher NLR (Yuan et al., 2020).”
§ Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: Effect of inflammatory biomarkers at three-month follow-up > Discussion
What the sources say
- Not checked yetcites Yuan et al., 2020 source
Strength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“In COVID-19, a dysexecutive syndrome in a third of survivors was described (Helms et al., 2020)”
§ Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: Effect of inflammatory biomarkers at three-month follow-up > Discussion
What the sources say
- Not checked yetcites Helms et al., 2020 source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“We also observed a protective effect against depression of cytokine-blocking agents (anakinra, a recombinant version of the human IL-1β receptor antagonist, and tocilizumab, a monoclonal antibody targeting the IL-6 receptor), possibly associated with their effect in dampening SII, in hospitalized male patients surviving severe, life-threatening COVID-19 (Benedetti et al., 2020b).”
§ Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: Effect of inflammatory biomarkers at three-month follow-up > Discussion
What the sources say
- Not checked yetcites Benedetti et al., 2020b
Strength:hedged· not yet calibratedCausal:conditional· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“and of IL-8, IL-10, TNF-α, IFN-γ with white matter (WM) microstructure, with levels of inflammatory cytokines being inversely related with measures of WM integrity (Benedetti et al., 2016)”
§ Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: Effect of inflammatory biomarkers at three-month follow-up > Discussion
What the sources say
- Not checked yetcites Benedetti et al., 2016 source
Load-bearingStrength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
Probably not a substantial claim.
In the paper
“Considering together three complementary cells mediating different immune or inflammatory pathways, SII is less affected by confounding conditions, and more predictive in evaluating chronic systemic inflammatory status than neutrophils, platelets or lymphocytes separately (Gibson et al., 2007).”
§ Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: Effect of inflammatory biomarkers at three-month follow-up > Discussion
What the sources say
- Not checked yetcites Gibson et al., 2007 source
Load-bearingStrength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
- Rests on an assumption: Platelets act as a nonspecific early inflammatory marker, mediating endothelial permeability and drawing neutrophils and macrophages and their effector functions.
In the paper
“as well as cognitive dysfunction in sustained attention domain possibly linked to the underlying inflammatory processes measured with CRP (Zhou et al., 2020a).”
§ Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: Effect of inflammatory biomarkers at three-month follow-up > Discussion
What the sources say
- Not checked yetcites Zhou et al., 2020a
Strength:hedged· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Many studies have implied that inflammation activation is inextricably linked to cognitive dysfunction suggesting a primary role of IL-1β, IL-6, IL-18, and TNF-α (Beydoun et al., 2019, Gorelick, 2010, McAfoose and Baune, 2009).”
§ Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: Effect of inflammatory biomarkers at three-month follow-up > Discussion
What the sources say
- Not checked yetcites Beydoun et al., 2019 source
- Not checked yetcites Gorelick, 2010 source
- Not checked yetcites McAfoose and Baune, 2009 source
Strength:hedged· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“In this context, we have previously found that higher inflammation, quantified by SII, is associated with higher depression in COVID-19 survivors (Mazza et al., 2020).”
§ Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: Effect of inflammatory biomarkers at three-month follow-up > Discussion
What the sources say
- Not checked yetcites Mazza et al., 2020 source
Strength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“the lifetime speed of information processing closely associates with WM microstructure in humans and in animal models (Bartzokis et al., 2012, Kochunov et al., 2007, Lu et al., 2013)”
§ Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: Effect of inflammatory biomarkers at three-month follow-up > Discussion
What the sources say
- Not checked yetcites Bartzokis et al., 2012 source
- Not checked yetcites Kochunov et al., 2007 source
- Not checked yetcites Lu et al., 2013
Load-bearingStrength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
Probably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“Recently, elevated NLR was described in mild cognitive impairment, while platelet/lymphocyte ratio and SII associated with risk of dementia in the general population (An et al., 2019, van der Willik et al., 2019).”
§ Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: Effect of inflammatory biomarkers at three-month follow-up > Discussion
What the sources say
- Not checked yetcites An et al., 2019
- Not checked yetcites van der Willik et al., 2019 source
Strength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“We also associated this WM phenotype with neurocognitive dysfunctions (Poletti et al., 2015)”
§ Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: Effect of inflammatory biomarkers at three-month follow-up > Discussion
What the sources say
- Not checked yetcites Poletti et al., 2015 source
Load-bearingStrength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
Probably not a substantial claim.
In the paper
“In patients with a depressive episode in course of Major Depressive Disorder (MDD) or Bipolar Disorder (BD), we have previously reported an association of peripheral IL-8, TNF-α, CCL2, CCL4 with cortical thickness (Poletti et al., 2019)”
§ Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: Effect of inflammatory biomarkers at three-month follow-up > Discussion
What the sources say
- Not checked yetcites Poletti et al., 2019 source
Strength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“of IL‐1β, IL-9, CCL5 with brain glutamate, N-acetylaspartate, and Myo-Inositol levels (Poletti et al., 2020a)”
§ Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: Effect of inflammatory biomarkers at three-month follow-up > Discussion
What the sources say
- Not checked yetcites Poletti et al., 2020a
Strength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“Neutrophils are critical for starting and regulating the innate immune defense through phagocytosis, apoptotic action, chemotactic role, oxidative stress, and secretion of inflammatory mediators (Nathan, 2006).”
§ Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: Effect of inflammatory biomarkers at three-month follow-up > Discussion
What the sources say
- Not checked yetcites Nathan, 2006 source
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“with levels of inflammatory cytokines being inversely related with measures of WM integrity (Benedetti et al., 2016)”
§ Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: Effect of inflammatory biomarkers at three-month follow-up > Discussion
What the sources say
- Not checked yetcites Benedetti et al., 2016 source
Strength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Depressed patients are characterized by higher levels of cytokines when compared to healthy controls with consistent results in literature when considering IL-1β, IL-6, IL-10, CCL2, TNF-α, and transforming growth factor-β (TGF-β) (Enache et al., 2019, Eyre et al., 2016, Howren et al., 2009, Kohler et al., 2017, Poletti et al., 2020b).”
§ Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: Effect of inflammatory biomarkers at three-month follow-up > Discussion
What the sources say
- Not checked yetcites Enache et al., 2019 source
- Not checked yetcites Eyre et al., 2016 source
- Not checked yetcites Howren et al., 2009 source
Strength:boosted· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“SII, considering together neutrophil, platelet, and lymphocyte, is an objective marker of the balance between host systemic inflammation and immune response (Huang et al., 2019).”
§ Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: Effect of inflammatory biomarkers at three-month follow-up > Discussion
What the sources say
- Not checked yetcites Huang et al., 2019 source
Load-bearingStrength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
Probably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“Several studies have proven that these inflammatory ratios can be used as inflammatory biomarkers in depression (Mazza et al., 2018, Wang et al., 2021, Zhou et al., 2020b).”
§ Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: Effect of inflammatory biomarkers at three-month follow-up > Discussion
What the sources say
- Not checked yetcites Mazza et al., 2018 source
- Not checked yetcites Wang et al., 2021 source
- Not checked yetcites Zhou et al., 2020b
Load-bearingStrength:boosted· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
Probably not a substantial claim.
In the paper
“Finally, lymphocytes are primarily involved in adaptive immunity, with a regulatory or protective function (Alberts, 2008).”
§ Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: Effect of inflammatory biomarkers at three-month follow-up > Discussion
What the sources say
- Not checked yetcites Alberts, 2008
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Inflammation is known to be associated to depression inducing brain-blood-barrier disruption, microglia activation, neurotransmission alteration, indoleamine 2,3-dioxygenase 1 (IDO) activation, and oxidative stress (Benedetti et al., 2020a, Miller and Raison, 2016).”
§ Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: Effect of inflammatory biomarkers at three-month follow-up > Discussion
What the sources say
- Not checked yetcites Benedetti et al., 2020a
- Not checked yetcites Miller and Raison, 2016 source
Load-bearingStrength:boosted· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
Probably not a substantial claim.
In the paper
“Platelet activation is mediated by serotonin, dopamine, glutamate, cytokines and P-selectin, all of them plays an important role in psychiatric disorders (Dietrich-Muszalska and Wachowicz, 2017).”
§ Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: Effect of inflammatory biomarkers at three-month follow-up > Discussion
What the sources say
- Not checked yetcites Dietrich-Muszalska and Wachowicz, 2017 source
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“an effect proportional to illness duration (Melloni et al., 2019)”
§ Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: Effect of inflammatory biomarkers at three-month follow-up > Discussion
What the sources say
- Not checked yetcites Melloni et al., 2019 source
Strength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“the public health implications of such effects will be significant and demanding for the psychiatric services”
§ Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: Effect of inflammatory biomarkers at three-month follow-up > Discussion
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✗ Checkable: fails✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it.
- Rests on an assumption: COVID-19 infection has a global burden.
In the paper
“NLR, MLR and SII are low-cost, suitable for clinical routine analysis, and reproducible markers of the systemic inflammatory response, which can be easily derived from blood cell essay and determined under simple laboratory conditions (Balta et al., 2013).”
§ Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: Effect of inflammatory biomarkers at three-month follow-up > Discussion
What the sources say
- Not checked yetcites Balta et al., 2013 source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

51 of 51

The paper relies on this without support.
The delayed or long-term incidence of neuropsychiatric complications in COVID-19 survivors is unknown.
“Beyond acute or sub-acute sequelae, the delayed or long-term incidence of neuropsychiatric complications in COVID-19 survivors are still unknown.”
The paper relies on this without support.
This was the first prospective study to investigate psychiatric and neurocognitive sequelae at medium-term follow-up in COVID-19 survivors.
“This is the first study to prospectively investigate the psychiatric and neurocognitive sequelae at a medium-term follow-up in COVID-19 survivors.”
The paper relies on this without support.
Platelets act as a nonspecific early inflammatory marker, mediating endothelial permeability and drawing neutrophils and macrophages and their effector functions.
“Platelets are an aspecific first line inflammatory marker that mediate endothelial permeability and recruitment of neutrophils and macrophages and their effector functions.”
The paper relies on this without support.
Depression is associated with a markedly increased risk of all-cause and cause-specific mortality.
“depression associates with a markedly increased risk of all-cause and cause-specific mortality”
The paper relies on this without support.
COVID-19 infection has a global burden.
“given the global burden of COVID-19 infection”

5 of 5

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Consistentz = 2.98reported p = .0026 · recomputed p = .003
“Z = 2.980, p = .0026”
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1 of 1

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BDI-13 clinical cutoff changes between methods and results
Minor
The methods define the BDI-13 cutoff as at least 9, but Table 1 counts patients using a cutoff of at least 8.
Cognitive-performance categories omit 21 assessed patients
Minor
The listed mutually exclusive categories total 109 patients, although the paper says cognitive functions were assessed in 130 patients. The account does not identify a category for the remaining 21.
Reported 130 · recomputed 109
Share with normal cognition changes from 19% to 22%
Minor
The results say 19% performed normally in every domain, while the discussion describes the same outcome as 22% of the sample.

3 of 3

A new look at the statistical model identification
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“A GLZM analysis of the effects of SII at hospital admission on severity of depression at three months, also considering sex, hospitalization, and age as factors, showed that best performing models according to AIC always included SII and significantly explained the variation of depression severity (χ2 = 56.536, p < 0.…”
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“T helper (Th)-1 cytokines, including Interleukin (IL)-1β, IL-6, Interferon (IFN)-γ, Tumor Necrosis Factor (TNF)-α, CXCL10, and CCL2; and Th-2 cytokines, including IL-4, IL-10, and IL-1 receptor antagonist are all elevated in the serum of COVID-19 patients (Coperchini et al., 2020) in a “cytokine storm” typically assoc…”
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WHO Coronavirus Disease (COVID-19) Dashboard
e, C. R. D. I. (2020) · Bangladesh Physiotherapy Journal · doi:10.46945/bpj.10.1.03.01 · Cited by 5,465
Molecular Biology of the Cell
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Pfefferbaum, B., & North, C. S. (2020) · New England Journal of Medicine · doi:10.1056/nejmp2008017 · Cited by 4,378 · cited 1×
“Moreover, significant stressors such as fear of severe and unknown disease, loneliness, stigma, and the denial contribute to widespread emotional distress and increased risk for psychiatric illness in COVID-19 patients (Pfefferbaum and North, 2020).”
The role of inflammation in depression: from evolutionary imperative to modern treatment target
Miller, A. H., & Raison, C. L. (2016) · Nature Reviews Immunology · doi:10.1038/nri.2015.5 · Cited by 3,942 · cited 2×
“…al. Brain Behavior and Immunity 94 (2021) 138–147 M.G. Mazza et al. Brain Behavior and Immunity 94 (2021) 138–147 disruption, microglia activation, neurotransmission alteration, indoleamine 2,3-dioxygenase 1 (IDO) activation, and oxidative stress (Benedetti et al., 2020a; Miller and Raison, 2016).”

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Items 501–526 of 526

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Authors: Mazza, M. G., Palladini, M., De Lorenzo, R., Magnaghi, C., Poletti, S., Furlan, R., Ciceri, F., Rovere-Querini, P., & Benedetti, F.
Affiliations: Vita-Salute San Raffaele University (IT)
IRCCS Ospedale San Raffaele (IT)
Corresponding author: Mazza, Mario Gennaro
ORCID: Mazza, Mario Gennaro
Palladini, Mariagrazia
Magnaghi, Cristiano
Poletti, Sara
Furlan, Roberto
Ciceri, Fabio
Benedetti, Francesco
Venue: Brain, Behavior, and Immunity
Publisher: Elsevier BV
Published: 2021-05
Volume: 94
Pages: 138-147
ISSN: 0889-1591 (ISSN-L)
DOI: 10.1016/j.bbi.2021.02.021
PMC: PMC7903920
OpenAlex: W3129342553
Semantic Scholar: 2c34e539a6d09867be7208e71f8a551c08e53ca0
Cited by: 513
References: 78
Citations by year: 2026: 23 · 2025: 66 · 2024: 109 · 2023: 148 · 2022: 115 · 2021: 50
FWCI: 50.55
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
doi.org/10.15223/policy-017 (stm-asf)
doi.org/10.15223/policy-037 (stm-asf)
doi.org/10.15223/policy-012 (stm-asf)
doi.org/10.15223/policy-029 (stm-asf)
doi.org/10.15223/policy-004 (stm-asf)
Locations: Brain Behavior and Immunity (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Archivio Istituzionale della Ricerca - Università Vita-Salute San Raffaele (submittedVersion)
Topics: Health Sciences › Medicine › Clinical Neurology › Long-Term Effects of COVID-19
Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
Keywords: COVID-19 pandemic, post-COVID-19 mental health, dysthymia, neurocognitive impairment, systemic inflammation, inflammatory markers, systemic immune-inflammation index, executive function, psychomotor coordination, verbal memory, verbal fluency, processing speed, long COVID
MeSH terms: COVID-19, SARS-CoV-2, Mental Disorders, Child, Preschool, Cognition Disorders, Follow-Up Studies, Humans, Male, Neuropsychological Tests, Prospective Studies, Biomarkers, Survivors

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Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: Effect of inflammatory biomarkers at three-month follow-up

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