Avaliação de marcadores inflamatórios e sua relação com sequelas cognitivas e psicológicas prolongadas autorrelatadas por pessoas idosas pós infecção por SARS-CoV-2

Abstract

The COVID-19 Pandemic that affected the entire world, and Brazil was the fourth most affected country, with the North and Northeast States being the most affected in the country. In this context, elderly people were quickly classified as the age group most susceptible to this condition, as they have a senescent immune system and are more likely to present chronic diseases mainly related to chronic inflammatory processes. Although social distancing has been an essential preventive mechanism, it promotes feelings of loneliness, influencing the onset or increasing the vulnerability of those who already have psychiatric disorder(s). This pandemic, in the last three years, raised concerns even after its conclusion, as although the majority of patients had fully recovered, some were left with long-term effects, called long COVID, especially among elderly people. These individuals experience functional and mental health sequelae. And inflammation is a point of convergence between viral diseases and the triggering or acceleration of mood, depressive and cognitive disorders.Thus, the objective of this study was to evaluate the relationship between cognitive and psychological sequelae in the elderly and the association with inflammatory markers. The method used was a prospective longitudinal study with an opportunistic sample of 62 participants aged 60 or over, followed for six months. Two groups were considered: elderly people who were not affected by COVID-19 (control group) and those who were. Firstly, a Likert-type scale was developed for self-reporting cognitive and psychological sequelae to evaluate these elderly people. Subsequently, interviews were carried out to analyze clinical and sociodemographic factors, the Geriatric Depression Scale (GDS-15) was applied and blood inflammatory markers were analyzed, such as C-reactive protein and interleukins IL1-β, TNF-α and IL-10. . The results were statistically analyzed through comparisons of means using the paired Student's t test for parametric data and one-way ANOVA for non-parametric data, with p < 0.05 considered statistically significant. As results obtained after infection, elderly people reported persistent sequelae, the main ones being memory loss and mood changes, including cases of anxiety and sadness, as well as difficulty sleeping. Both self-reported memory and mood alteration sequelae persisted throughout the six months of the study. Inflammatory markers, including CRP, IL-1β, TNF-α, and IL-10, were significantly higher in the infected group compared to the control group (those not infected), and these levels remained elevated after six months in the infected group. In conclusion, this study highlights that the cognitive and psychological sequelae caused by SARS-CoV-2 infection persist in elderly people in the long term. Furthermore, a relationship between inflammation and psychological and cognitive disorders was evident, corroborating previous findings about other viruses. However, more research is needed to better understand the underlying causes and contribute to the treatment of these prolonged sequelae.