Clinical and biochemical characteristics of schizophrenia patients with and without COVID-19: A retrospective study

doi:10.21203/rs.3.rs-3222646/v1

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Clinical and biochemical characteristics of schizophrenia patients with and without COVID-19: A retrospective study

https://doi.org/10.21203/rs.3.rs-3222646/v1

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Background

Previous studies have shown that patients with mental diseases such as schizophrenia are at high risk of coronavirus disease 2019 (COVID-19). However, the clinical characteristics of patients with schizophrenia and COVID-19 remain unknown. The aim of this study was to investigate the differences in clinical biochemical values between schizophrenia patients with and without COVID-19.

Methods

We undertook an exploratory, retrospective review of patient data from Dec. 6, 2022, to Jan. 31, 2023. A total of 1696 inpatients with psychosis (921 schizophrenia patients and 775 diagnosed with other mental diseases) during this period were identified. Finally, 60 schizophrenia patients were enrolled in our study, and 20 of them were infected with syndrome coronavirus 2 (SARS-CoV-2).

Results

The serum biochemical levels, blood cell counts and single-cell mitochondrial mass (SCMM) of the T lymphocytes of all schizophrenia patients were analyzed. Schizophrenia patients with COVID-19 (SCZ-C) showed higher serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), creatinine (Cr), uric acid (UA), lactate dehydrogenase (LDH), myoglobin (Myo), and C-reactive protein (CRP) and platelet counts and a significant decrease in lymphocyte, monocyte, eosinophil, and basophil cell counts. In addition, positive correlations were found between the T-cell subpopulation counts and positive symptom scores on the Positive and Negative Syndrome Scale (PANSS).

Conclusion

Our study findings showed that schizophrenia patients with COVID-19 have a phenotype of mitochondrial damage in peripheral blood T lymphocytes and may have liver, heart and kidney damage compared with SARS-CoV-2-negative schizophrenia patients.

Schizophrenia

COVID-19

Biochemical characteristics

Mitochondrial damage

COVID-19 caused by SARS-CoV-2 infection has been raging worldwide since January 2020, bringing major challenges to public health and medical communities around the world [1]. Although the pathogenicity of the Omicron variant is considered to be significantly attenuated, the COVID-19 pandemic remains a worldwide public health crisis [2, 3]. In addition to the general population, schizophrenia patients have received extensive attention from many psychiatrists [4]. Several studies revealed that the incidence of COVID-19 was higher in schizophrenia patients than in those without psychiatric diagnoses [5, 6]. Furthermore, people living with schizophrenia were found to be at greater risk for adverse outcomes, including death [7]. High-risk factors included failure to properly recognize self-protection needs [8], greater socioeconomic disadvantage [9] and being more socially disconnected [7]. Protecting the mental health of these patients is thus important not only for their own long-term health but also for the control of the pandemic [10].

Coronavirus infection itself may exacerbate symptoms in people with schizophrenia, as coronaviruses may be associated with symptoms of psychosis through an immune-related mechanism [11]. It can be said that COVID-19 can cause several changes in the human immune system that are known possible etiologies of schizophrenia [12]. Previous studies have shown that COVID-19 has various psychosocial effects on schizophrenia patients [5, 7, 13]. At the same time, SARS-CoV-2 infection might present as liver injury, kidney injury, cardiac failure and mitochondriopathy [14–17]. To date, no studies have reported the clinical manifestations or serum biochemical values of schizophrenia patients infected with SARS-CoV-2. To effectively prioritize resources for schizophrenia patients, the identification of clinical and laboratory biochemical markers is urgently needed.

In this study, we retrospectively analyzed the differences in the serum biochemical levels, blood cell counts and SCMM of T lymphocytes between schizophrenia patients with and without SARS-CoV-2 infection and evaluated the relationship between these values and symptoms of psychosis. The aim of this research is to provide an objective index for schizophrenia patients with COVID-19 to help with their treatment.

Study population

In this retrospective observational study, schizophrenia patients in Xiamen Xianyue Hospital, Xiamen Mental Health Center in Fujian, China, between December 6, 2022 and January 31, 2023, were enrolled. A total of 1696 inpatients with psychosis (921 schizophrenia patients and 775 diagnosed with other mental diseases) during this period were identified. Patients who met the following criteria were included: i) meeting the diagnostic criteria for schizophrenia according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV); ii) having complete clinical and biological data; and iii) aged 18–70 years. Patients with allergies, autoimmune disorders, a history of substance abuse, other mental illnesses, cancer, hypertension, coronary heart disease, diabetes, nervous system diseases or other infectious diseases were excluded. The flow chart of participant enrollment is shown in Fig. 1. Finally, 60 schizophrenia patients were enrolled in this study. Then, 20 schizophrenia patients with laboratory-confirmed COVID-19 represented the schizophrenia-COVID-19 (SCZ-C) group. The remaining 40 schizophrenia patients represented the schizophrenia (SCZ) group.

Data collection and processing

Demographic and clinical data, including sex, age, body mass index (BMI), years of education and mental disorder duration, were collected. The severity of symptoms of psychosis was evaluated using the PANSS.

The laboratory data, including flow cytometry data, blood cell counts and biochemical test results, were collected. Flow cytometry was performed using Novocyte (Agilent Technologies, USA), and flow cytometry antibodies CD3-FITC/CD8-PE/CD4-PE-Cy7/CD45-PerCP-Cy5.5 and Mito dye were produced by UBBIO LTD (Zhejiang, China). The flow cytometry data included the percentage and absolute counts of lymphocytes, T cells (CD3⁺), helper T cells (Th cells: CD3⁺ CD4⁺) and killer T cells (TS cells: CD3⁺ CD8⁺), as well as the SCMM (single-cell mitochondrial mass) of each subset. The SCMM of T lymphocytes was obtained by calculating the absolute count of the mitochondrial mass (MM) and cells [18, 19]. The T-cell subsets and the fluorescence intensity of mitochondria of each cell population are shown in Fig. 2 and Fig. 3. Data analysis was performed using FlowJo software v10.8.1.

Serum biochemical tests such as tests of lipid profiles and serum levels of liver, kidney, heart function and serum electrolytes were performed using a Beckman AU5800 automatic biochemistry analyzer (Beckmann, USA). Other laboratory data, including the counts of white blood cells, red blood cells, platelets, neutrophils, lymphocytes, monocytes, eosinophils, basophils and hemoglobin, were determined by an XN 10 automated hematology analyzer (Sysmex, Japan). This study was approved by the Institutional Ethics Committee of Xiamen Xianyue Hospital, Xiamen Mental Health Center (No. 2022-KY-034).

Reverse transcriptase-polymerase chain reaction (RT-PCR) assay for SARS-CoV-2 infection

The RT‒PCR test was performed using nasopharyngeal and oropharyngeal samples taken from the patients [20]. A Daan 2019-nCoV RT‒PCR Kit (Daan Gene, China) targeting open reading frame 1a or 1b (ORF1ab) and the nucleocapsid protein (N) gene was used to detect SARS-CoV-2 according to the manufacturer’s instructions. All reactions were carried out with a SLAN®-96S Real‐Time PCR System (Hongshi Medical Technology Co., Ltd., China).

Statistical analysis

All statistical analyses were performed using SPSS v20.0 software (SPSS, Inc.). The results are expressed as the mean ± standard deviation. The variables were compared using Student’s t test, while non-normally distributed variables were compared using Mann‒Whitney U tests. Qualitative variables were analyzed using the chi-square test. Correlation analysis was performed with the Spearman’s rank correlation coefficient. The correlation coefficients of these relationships were represented by a heatmap. The significance level was set at P < 0.05.

Patient demographics and characteristics

The present study consisted of 60 schizophrenia patients, 20 of whom were confirmed by laboratory tests to have COVID-19. The demographic and clinical characteristics are shown in Table 1. No significant differences were found in sex (P = 0.641), age (P = 0.493), BMI (P = 0.341), years of education (P = 0.489) or mental disorder duration (P = 0.858) between the SCZ-C and SCZ groups.

Table 1

Demographic and clinical characteristics of two groups.
Variables	SCZ-C group	SCZ group	P-value
General, n
Gender
Male	16	32	0.641^a
Female	4	8
Age, mean (range)	44(21–61)	43.6(19–67)	0.493^b
BMI(kg/m²), mean ± SD	24.12 ± 4.95	22.80 ± 3.69	0.341
Education(y), mean ± SD	10.39 ± 3.63	10.24 ± 3.26	0.489
Mental disorder duration(y), mean ± SD	16.12 ± 9.76	18.37 ± 10.33	0.858
PANSS score, mean ± SD
PANSS-P	9.50 ± 3.50	10.65 ± 5.71	0.048
PANSS-N	11.85 ± 4.00	13.83 ± 4.50	0.634
PANSS-G	18.50 ± 1.79	19.13 ± 2.43	0.074
PANSS-T	42.90 ± 6.21	46.80 ± 8.64	0.318
SD: standard deviation.
a: P value calculated by Chi-squared test.
b: P value calculated by Mann‒Whitney U tests.

Comparison of laboratory data between the two groups

Significantly lower CD3⁺, CD3⁺CD4⁺ and CD3⁺CD8⁺ T-cell counts were observed in the SCZ-C group (Fig. 2d), while the mitochondrial mass of each subset was higher in the SCZ-C group (P < 0.05) (Fig. 3d). Univariate analysis was performed for blood cell counts and biochemical tests (Tables 2–3). The analysis of blood cell counts showed lower lymphocyte, monocyte, eosinophil, and basophil cell counts and higher platelet counts in the SCZ-C group (P < 0.05) (Table 2). Regarding serum biochemical test results, the serum levels of liver, kidney and heart function indicators showed a large discrepancy between the two groups. Among them, the levels of ALT, AST, ALP, Cr, UA, LDH, Myo and CRP were considerably higher in the SCZ-C group (P < 0.05) (Table 3).

Table 2

Comparison of blood cell counts between two groups.
Variables	SCZ-C group	SCZ group	P-value
White blood cells(10⁹/L)	6.68 ± 2.29	7.04 ± 1.57	0.287
Red blood cells(10¹²/L)	4.46 ± 0.62	4.57 ± 0.46	0.151
Hemoglobin(g/L)	135.58 ± 18.74	139.38 ± 13.42	0.053
Platelets(10⁹/L)	204.74 ± 71.37	231.10 ± 39.36	0.010^a
Neutrophils(10⁹/L)	4.26 ± 1.63	3.89 ± 1.50	0.375^a
Lymphocytes(10⁹/L)	1.52 ± 0.91	2.33 ± 0.66	0.018
Monocytes(10⁹/L)	0.81 ± 0.31	0.56 ± 0.15	0.000
Eosinophils(10⁹/L)	0.08 ± 0.08	0.23 ± 0.19	0.000^a
Basophils(10⁹/L)	0.02 ± 0.01	0.04 ± 0.02	0.002^a
a: P value calculated by Mann‒Whitney U tests.

Table 3

Comparison of serum biochemical test between two groups.
Variables	SCZ-C group	SCZ group	P-value
ALT(U/L)	30.69 ± 24.23	24.36 ± 12.57	0.035
AST(U/L)	57.95 ± 92.91	24.11 ± 7.17	0.009^a
ALP(U/L)	72.53 ± 16.21	85.04 ± 23.75	0.034
GGT(U/L)	22.01 ± 13.74	22.26 ± 12.74	0.816
ALB(g/L)	42.86 ± 6.15	44.66 ± 3.53	0.426^a
GLO(g/L)	25.21 ± 3.08	25.29 ± 4.72	0.125
TBIL(umol/L)	10.35 ± 4.94	10.99 ± 5.24	0.596^a
DBIL(umol/L)	2.21 ± 1.14	2.33 ± 1.32	0.829^a
TG(mmol/L)	1.30 ± 0.77	1.30 ± 0.64	0.868^a
CHO(mmol/L)	4.62 ± 0.97	4.91 ± 1.02	0.394^a
HDL-C(mmol/L)	1.17 ± 0.29	1.37 ± 0.46	0.451
LDL-C(mmol/L)	3.12 ± 0.89	3.19 ± 0.67	0.094
apoA(g/L)	1.03 ± 0.18	1.22 ± 0.33	0.057^a
apoB(g/L)	0.88 ± 0.24	0.91 ± 0.23	0.987
Urea(mmol/L)	3.57 ± 1.34	4.15 ± 0.89	0.074
Cr(umol/L)	78.40 ± 18.25	68.44 ± 13.72	0.048^a
UA(umol/L)	352.13 ± 116.74	328.22 ± 80.95	0.036^a
CK(U/L)	321.67 ± 426.15	118.15 ± 10.93	0.092^a
LDH(U/L)	196.63 ± 76.32	157.66 ± 38.77	0.023^a
CKMB(U/L)	11.47 ± 5.56	11.35 ± 5.01	0.869^a
Myo(ng/mL)	62.47 ± 70.38	37.25 ± 51.36	0.033^a
TnT(ng/L)	9.51 ± 6.35	8.59 ± 3.46	0.763^a
Na(mmol/L)	140.15 ± 3.89	141.27 ± 1.98	0.063^a
K(mmol/L)	4.05 ± 0.35	4.09 ± 0.36	0.623
Cl(mmol/L)	104.73 ± 3.94	105.28 ± 2.77	0.211^a
Ca(mmol/L)	2.33 ± 0.12	2.37 ± 0.08	0.297
P(mmol/L)	1.35 ± 0.21	1.32 ± 0.22	0.687
Mg(mmol/L)	0.87 ± 0.08	0.89 ± 0.06	0.765^a
CRP(mg/L)	8.23 ± 10.95	1.22 ± 2.82	0.000^a
a: P value calculated by Mann‒Whitney U tests.

Relationship between laboratory data and PANSS scores

To further determine whether there were any relationships between the laboratory data and symptoms of psychosis of SCZ-C patients, we analyzed the association between laboratory data and PANSS scores (Fig. 4). There were no significant correlations between clinical laboratory data and PANSS scores, although the CD3⁺, CD3⁺CD4⁺ and CD3⁺CD8⁺ cell counts were positively correlated with the PANSS-P score (P < 0.05).

Because of the rapid spread and uncertainty of the virus, COVID-19 still remains a major public health problem. Particularly, the association between COVID-19 and mental disorders appears to be bidirectional [21]. Psychiatric patients might be at higher risk of COVID-19 infection, and COVID-19 survivors have an increased risk of adverse mental health outcomes [22]. Some previous work discussed the impact of the COVID-19 pandemic on schizophrenia patients [5, 6] and proposed recommendations to mitigate the adverse consequences of COVID-19 on persons with schizophrenia [7].

In the present study, we firstly compared the blood T-cell subpopulations and SCMM using flow cytometry between the SCZ-C group and the SCZ group. The results showed that the cell counts of CD3⁺, CD3⁺CD4⁺ and CD3⁺CD8⁺ T lymphocytes were significantly lower in the SCZ-C group, compared to the SCZ group. A previous study revealed that the decline in lymphocyte counts was one characteristic of COVID-19 [23], which was in line with our results. Furthermore, we found that the SCMM of T lymphocytes was significantly higher in schizophrenia patients with COVID-19 than in those without COVID-19. SCMM can sensitively reflect the function of cell mitochondria, which is a new index in the evaluation of cell mitochondrial function [19]. Some researchers revealed that mitochondrial dysfunction might be associated with mental disorders [24]. In addition, acute recurrence of schizophrenia might be related to elevated levels of mitochondrial damage in peripheral blood T lymphocytes [25]. The higher SCMM in peripheral blood T lymphocytes reflects abnormal mitochondrial metabolism, which can result in decreased energy generation. According to our research, mitochondria may represent critical mediators and serve as strategic therapeutic targets in schizophrenia patients who were infected with SARS-CoV-2.

Meanwhile, significantly lower lymphocyte, monocyte, eosinophil, and basophil cell counts were found in the SCZ-C group, which was consistent with many other studies [26, 27]. Lower eosinophil and basophil counts were reported to be related to delayed recovery in COVID-19 patients [28]. Moreover, the platelet counts of the SCZ-C group were lower than those of the SCZ group. Platelets were very important in thrombosis, injury response and immunoregulation. Decreased platelet counts may lead to increased mortality in COVID-19 patients [29].

SARS-CoV-2 infection can increase liver enzymes by affecting liver function. Inflammation and liver toxicity induced by multidrug therapy may be the main causes of elevated liver enzymes observed in COVID-19 patients [30]. Additionally, kidney injury and heart failure are also common in patients with COVID-19 [31, 32]. Some authors have reported higher CRP levels in SARS-CoV-2-positive patients, indicating an enhanced inflammatory response in these patients [32, 33]. However, it remains uncertain how biochemical levels change in patients with SARS-CoV-2-positive schizophrenia. In the present study, we found abnormally higher levels of liver enzymes, including ALT, AST and ALP, in the SCZ-C group, while such a difference was not observed in serum GGT levels. On the other hand, we need to pay more attentions to heart damage in schizophrenia patients with COVID-19, when the levels of myocardial enzymes such as LDH and Myo were much higher than in patients who were not infected with SARS-CoV-2. The levels of Cr and UA were also increased remarkably in SARS-CoV-2-positive schizophrenia patients, which are the signs for kidney dysfunction. We also observed that the level of CRP, which is the major indicator of inflammation, was significantly increased in the SCZ-C group. To sum up, our findings showed that schizophrenia patients with COVID-19 have a phenotype of systemic metabolic dysfunction and may have liver, heart and kidney damage.

At the end of the study, we conducted a correlation analysis of laboratory data and PANSS scores in the SCZ-C group. We found that the CD3⁺, CD3⁺CD4⁺ and CD3⁺CD8⁺ cell counts were positively correlated with the PANSS-P score; accordingly, the SCMM of each T-cell subset was negatively correlated with the PANSS-P score. Saleh et al discussed mitochondrial dysfunction in COVID-19 patients [34]. Furthermore, many studies have suggested a relationship between mitochondrial damage and PANSS scores [25, 35]. To some extent, mitochondrial damage in lymphocytes can be used as a biomarker of treatment response, which may be helpful for the treatment of schizophrenia patients infected with SARS-CoV-2. There were no significant associations between other biochemical data and PANSS scores, which might be attributed to the insufficient sample size.

This retrospective study was the first to explore the biochemical characteristics, including the mitochondrial mass of T lymphocytes, blood cell counts and serum biochemical levels, of SARS-CoV-2-positive schizophrenia patients. Our study is not exempt from limitations. The relatively small sample size because of missing data might have reduced the statistical power to detect significant relationships. Additionally, as this study was conducted in a psychiatric hospital, we studied only inpatients with schizophrenia, and the data of healthy controls were unavailable. Further prospective studies are needed to evaluate the clinical biochemical levels of SARS-CoV-2-positive schizophrenia patients in combination with medication situations.

Our data confirmed that schizophrenia patients with COVID-19 present significant mitochondrial damage in T lymphocytes; a sharp increase in serum ALT, AST, ALP, Cr, UA, LDH, Myo, and CRP levels as well as platelet counts; and a significant decrease in lymphocyte, monocyte, eosinophil, and basophil cell counts. Positive correlations were found between the T-cell subpopulations (the CD3⁺, CD3⁺CD4⁺ and CD3⁺CD8⁺ cell counts) and PANSS-P scores. This is the first study to characterize the biochemical values in SARS-CoV-2-positive schizophrenia patients, and we expect the findings to provide useful evidence for the treatment of these individuals.

COVID-19: coronavirus disease 2019; SARS-CoV-2: syndrome coronavirus 2; SCMM: single-cell mitochondrial mass; PANSS: positive and negative syndrome scale; PANSS-N: the negative symptom score of PANSS; PANSS-P: the positive symptom score of PANSS; PANSS-G: the general psychopathology score of PANSS; PANSS-T: the total PANSS score; BMI: body mass index; ALT: alanine aminotransferase; AST: aspartate aminotransferase; ALP: alkaline phosphatase; GGT: γ-glutamyltransferase; ALB: albumin; GLO: globin; TBIL: total bilirubin; DBIL: direct bilirubin; TG: triglyceride; CHO: cholesterol; HDL-C: high density lipoprotein cholesterol; LDL-C: low density lipoprotein cholesterol; apoA : apolipoprotein A; apoB: apolipoprotein B; Cr: creatinine; UA: uric acid; CK: creatine kinase; LDH: lactate dehydrogenase; CK-MB: creatine kinase-MB; Myo: myoglobin; TnT: troponin T; Na: nodium; K: potassium; Cl: chloride; Ca: calcium; P: phosphorus; Mg: magnesium; CRP: C-reactive protein.

Acknowledgements

Not applicable.

Authors’ contribution

Conception and design of the study: PY, FL. Acquisition and analysis of data: QZ, LS. Manuscript drafting: QZ, HD. Figures and tables drafting: QZ, YB. All authors contributed to and have approved the final manuscript.

Funding

This work was supported by China Scholarship Council: [Grant number 201809350002]; the Guiding Projects of Xiamen Science and Technology Program [Grant number 350Z20224ZD1314].

Availability of data and materials

The data used during the current study are available from the corresponding author on reasonable request, the data are anonymized.

Conﬂict of interest

The authors declare that they have no competing interests.

Ethics approval and consent to participate

Ethical approval was obtained from the Xiamen Xianyue Hospital Ethical Committee. Permission to access patients’ records was also sought from the Management of Xiamen Xianyue Hospital. The need for informed consent was waived by the the Xiamen Xianyue Hospital Ethical Committee.

Consent for publication

No patient identifiable information has been reported.

Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, Ren R, Leung KSM, Lau EHY, Wong JY et al: Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia. N Engl J Med 2020; 382(13):1199-207.http://doi.org/10.1056/NEJMoa2001316
Suzuki R, Yamasoba D, Kimura I, Wang L, Kishimoto M, Ito J, Morioka Y, Nao N, Nasser H, Uriu K et al: Attenuated fusogenicity and pathogenicity of SARS-CoV-2 Omicron variant. Nature 2022; 603(7902):700-5.http://doi.org/10.1038/s41586-022-04462-1
Gao SJ, Guo H, Luo G: Omicron variant (B.1.1.529) of SARS-CoV-2, a global urgent public health alert! J Med Virol 2022; 94(4):1255-6.http://doi.org/10.1002/jmv.27491
Zhand N, Joober R: Implications of the COVID-19 pandemic for patients with schizophrenia spectrum disorders: narrative review. BJPsych Open 2021; 7(1):e35.http://doi.org/10.1192/bjo.2020.157
Barlati S, Nibbio G, Vita A: Schizophrenia during the COVID-19 pandemic. Curr Opin Psychiatry 2021; 34(3):203-10.http://doi.org/10.1097/YCO.0000000000000702
Wang Q, Xu R, Volkow ND: Increased risk of COVID-19 infection and mortality in people with mental disorders: analysis from electronic health records in the United States. World Psychiatry 2021; 20(1):124-30.http://doi.org/10.1002/wps.20806
Kozloff N, Mulsant BH, Stergiopoulos V, Voineskos AN: The COVID-19 Global Pandemic: Implications for People With Schizophrenia and Related Disorders. Schizophr Bull 2020; 46(4):752-7.http://doi.org/10.1093/schbul/sbaa051
Yao H, Chen JH, Xu YF: Patients with mental health disorders in the COVID-19 epidemic. Lancet Psychiatry 2020; 7(4):e21.http://doi.org/10.1016/S2215-0366(20)30090-0
Shinn AK, Viron M: Perspectives on the COVID-19 Pandemic and Individuals With Serious Mental Illness. J Clin Psychiatry 2020; 81(3).http://doi.org/10.4088/JCP.20com13412
Percudani M, Panariello A, Deste G, Bassetti R, Borriello G, Cecchetto F, Marco BD, Falini A, Nibbio G, Calzavara-Pinton I et al: Socio-demographic and clinical characteristics of SARS-CoV-2-positive psychiatric in-patients: A case-control study in the psychiatric wards of a Great Metropolitan Hospital in Milan. Psychiatry Res 2023; 322:115042.http://doi.org/10.1016/j.psychres.2022.115042
Severance EG, Dickerson FB, Viscidi RP, Bossis I, Stallings CR, Origoni AE, Sullens A, Yolken RH: Coronavirus immunoreactivity in individuals with a recent onset of psychotic symptoms. Schizophr Bull 2011; 37(1):101-7.http://doi.org/10.1093/schbul/sbp052
Pourfridoni M, Askarpour H: COVID-19 and the increase in schizophrenia incidence in the future: A hypothesis and a serious warning. Health Sci Rep 2023; 6(1):e978.http://doi.org/10.1002/hsr2.978
Cheng X, Huang X, Wu X, Lin S: Impact of the COVID-19 pandemic on lifestyle and mental state in patients with schizophrenia: A retrospective study. Medicine (Baltimore) 2023; 102(5):e32830.http://doi.org/10.1097/MD.0000000000032830
Sanchez-Recalde A, Solano-Lopez J, Miguelena-Hycka J, Martin-Pinacho JJ, Sanmartin M, Zamorano JL: COVID-19 and cardiogenic shock. Different cardiovascular presentations with high mortality. Rev Esp Cardiol (Engl Ed) 2020; 73(8):669-72.http://doi.org/10.1016/j.rec.2020.04.012
Lim JH, Park SH, Jeon Y, Cho JH, Jung HY, Choi JY, Kim CD, Lee YH, Seo H, Lee J et al: Fatal Outcomes of COVID-19 in Patients with Severe Acute Kidney Injury. J Clin Med 2020; 9(6).http://doi.org/10.3390/jcm9061718
Dong X, Sun L, Li Y: Prognostic value of lactate dehydrogenase for in-hospital mortality in severe and critically ill patients with COVID-19. Int J Med Sci 2020; 17(14):2225-31.http://doi.org/10.7150/ijms.47604
Alfarouk KO, Alhoufie STS, Hifny A, Schwartz L, Alqahtani AS, Ahmed SBM, Alqahtani AM, Alqahtani SS, Muddathir AK, Ali H et al: Of mitochondrion and COVID-19. J Enzyme Inhib Med Chem 2021; 36(1):1258-67.http://doi.org/10.1080/14756366.2021.1937144
Clutton G, Mollan K, Hudgens M, Goonetilleke N: A Reproducible, Objective Method Using MitoTracker(R) Fluorescent Dyes to Assess Mitochondrial Mass in T Cells by Flow Cytometry. Cytometry A 2019; 95(4):450-6.http://doi.org/10.1002/cyto.a.23705
Pang LX, Cai WW, Chen L, Fu J, Xia CX, Li JY, Li Q: The Diagnostic Value of Mitochondrial Mass of Peripheral T Lymphocytes in Early Sepsis. Front Public Health 2022; 10:928306.http://doi.org/10.3389/fpubh.2022.928306
Chen YY, Shen X, Wang YJ, Xie JW, Fang ZX, Lin LR, Yang TC: Evaluation of the cycle threshold values of RT-PCR for SARS-CoV-2 in COVID-19 patients in predicting epidemic dynamics and monitoring surface contamination. J Infect Public Health 2022; 15(12):1494-6.http://doi.org/10.1016/j.jiph.2022.11.012
Taquet M, Luciano S, Geddes JR, Harrison PJ: Bidirectional associations between COVID-19 and psychiatric disorder: retrospective cohort studies of 62 354 COVID-19 cases in the USA. Lancet Psychiatry 2021; 8(2):130-40.http://doi.org/10.1016/S2215-0366(20)30462-4
Fonseca L, Diniz E, Mendonça G, Malinowski F, Mari J, Gadelha A: Schizophrenia and COVID-19: risks and recommendations. Brazilian Journal of Psychiatry 2020; 42(3):236-8.http://doi.org/10.1590/1516-4446-2020-0010
Terpos E, Ntanasis-Stathopoulos I, Elalamy I, Kastritis E, Sergentanis TN, Politou M, Psaltopoulou T, Gerotziafas G, Dimopoulos MA: Hematological findings and complications of COVID-19. Am J Hematol 2020; 95(7):834-47.http://doi.org/10.1002/ajh.25829
Robicsek O, Karry R, Petit I, Salman-Kesner N, Muller FJ, Klein E, Aberdam D, Ben-Shachar D: Abnormal neuronal differentiation and mitochondrial dysfunction in hair follicle-derived induced pluripotent stem cells of schizophrenia patients. Mol Psychiatry 2013; 18(10):1067-76.http://doi.org/10.1038/mp.2013.67
Hu A, Li F, Guo L, Zhao X, Xiang X: Mitochondrial Damage of Lymphocytes in Patients with Acute Relapse of Schizophrenia: A Correlational Study with Efficacy and Clinical Symptoms. Neuropsychiatr Dis Treat 2022; 18:2455-66.http://doi.org/10.2147/NDT.S380353
Alfadda AA, AlKhowaiter M, Alotaibi N, Alayed K, Alzahrani M, Binkhamis K, Siddiqui K, Youssef A, Altalhi H, Almaghlouth I et al: Clinical and biochemical characteristics and outcomes of suspected COVID-19 hospitalized patients: RT-PCR swab positive and negative comparison. J Infect Public Health 2021; 14(11):1623-9.http://doi.org/10.1016/j.jiph.2021.09.014
Diao B, Wang C, Tan Y, Chen X, Liu Y, Ning L, Chen L, Li M, Liu Y, Wang G et al: Reduction and Functional Exhaustion of T Cells in Patients With Coronavirus Disease 2019 (COVID-19). Front Immunol 2020; 11:827.http://doi.org/10.3389/fimmu.2020.00827
Mao J, Dai R, Du RC, Zhu Y, Shui LP, Luo XH: Hematologic changes predict clinical outcome in recovered patients with COVID-19. Ann Hematol 2021; 100(3):675-89.http://doi.org/10.1007/s00277-021-04426-x
Tang N, Li D, Wang X, Sun Z: Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost 2020; 18(4):844-7.http://doi.org/10.1111/jth.14768
Clark R, Waters B, Stanfill AG: Elevated liver function tests in COVID-19: Causes, clinical evidence, and potential treatments. Nurse Pract 2021; 46(1):21-6.http://doi.org/10.1097/01.NPR.0000722316.63824.f9
Nugent J, Aklilu A, Yamamoto Y, Simonov M, Li F, Biswas A, Ghazi L, Greenberg H, Mansour G, Moledina G et al: Assessment of Acute Kidney Injury and Longitudinal Kidney Function After Hospital Discharge Among Patients With and Without COVID-19. JAMA Netw Open 2021; 4(3):e211095.http://doi.org/10.1001/jamanetworkopen.2021.1095
Qi X, Kong H, Ding W, Wu C, Ji N, Huang M, Li T, Wang X, Wen J, Wu W et al: Abnormal Coagulation Function of Patients With COVID-19 Is Significantly Related to Hypocalcemia and Severe Inflammation. Front Med (Lausanne) 2021; 8:638194.http://doi.org/10.3389/fmed.2021.638194
Mokhtari T, Hassani F, Ghaffari N, Ebrahimi B, Yarahmadi A, Hassanzadeh G: COVID-19 and multiorgan failure: A narrative review on potential mechanisms. J Mol Histol 2020; 51(6):613-28.http://doi.org/10.1007/s10735-020-09915-3
Saleh J, Peyssonnaux C, Singh KK, Edeas M: Mitochondria and microbiota dysfunction in COVID-19 pathogenesis. Mitochondrion 2020; 54:1-7.http://doi.org/10.1016/j.mito.2020.06.008
Leirer DJ, Iyegbe CO, Di Forti M, Patel H, Carra E, Fraietta S, Colizzi M, Mondelli V, Quattrone D, Lally J et al: Differential gene expression analysis in blood of first episode psychosis patients. Schizophr Res 2019; 209:88-97.http://doi.org/10.1016/j.schres.2019.05.011

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Clinical and biochemical characteristics of schizophrenia patients with and without COVID-19: A retrospective study

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Abstract

Background

Methods

Results

Conclusion

Figures

Introduction

Methods

Study population

Data collection and processing

Reverse transcriptase-polymerase chain reaction (RT-PCR) assay for SARS-CoV-2 infection

Statistical analysis

Results

Patient demographics and characteristics

Comparison of laboratory data between the two groups

Relationship between laboratory data and PANSS scores

Discussion

Conclusion

Abbreviations

Declarations

References

Additional Declarations

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