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European Journal of Psychiatry
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Vol. 37. Issue 2.
Pages 125-132 (April - June 2023)
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Vol. 37. Issue 2.
Pages 125-132 (April - June 2023)
Original article
Comparison of inflammation markers and severity of illness among patients with COVID-19, acute psychiatric disorders and comorbidity
Özgecan Tunaa,
Corresponding author

Corresponding author.
, Cagatay Ermisb, Asli Enez Darcinc, Ekin Dagistand, Serdar Salmand
a Department of Psychiatry, Kanuni Sultan Süleyman Training and Research Hospital, Turkey
b Department of Child and Adolescent Psychiatry, Diyarbakır Childrens' Hospital, Turkey
c İstanbul Ayvansaray University, Turkey
d Department of Psychiatry, Istanbul Bakirkoy Prof Dr. Mazhar Osman Ruh Mental and Nervous Diseases Training and Research Hospital, Turkey
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Background and objectives

Neutrophil, lymphocyte counts, lactate dehydrogenase (LDH), D-dimer, fibrinogen, and comorbid illness are associated with the course and prognosis of COVID-19. However, the course of acute severe psychiatric disorders overlapping with COVID-19 infection was not investigated and remained as an unclarified research area. This study aimed to demonstrate inflammatory markers and the course of patients suffering from both conditions.


Thirty-eight inpatients with COVID-19 and comorbid acute psychiatric disorders (COVID-19+PD), 31 inpatients with COVID-19, and 38 inpatients with an acute psychiatric disorder (PD) were included in the study. Neutrophil, lymphocyte counts, serum ferritin, lactate dehydrogenase (LDH), D-dimer, fibrinogen, Systemic immune-inflammation index (SII), neutrophil/lymphocyte ratio (NLR), and C-reactive protein (CRP) were compared to evaluate inflammation levels.


Patients with SARS-CoV-2 infection had older age compared to the PD group. CALL (Comorbidity, age, lymphocyte, lactate dehydrogenase) scores which predict the progression risk in patients with COVID-19 pneumonia, of both COVID-19 groups were found similar. The COVID-19+PD had higher SII in the study sample. Additionally, the COVID-19+PD group had higher NLR, ferritin, and CRP levels than those of the PD group.


The prognosis of COVID-19 is not worse when accompanied by a psychiatric disorder. Laboratory assessment can guide clinicians to distinguish those infected with SARS-CoV-2 within psychiatric inpatient units. The biochemical assessment did not robustly support higher inflammatory levels in the comorbid COVID-19 and psychiatric disorder group compared to the COVID-19 group.

Psychiatric disorder
Absolute neutrophil count
Alanine aminotransferase
COVID-19 and psychiatric disorder group
C-reactive protein
Lactate dehydrogenase
Neutrophil/lymphocyte ratio
Polymerase Chain Reaction
Psychiatric disorder group
Systemic immune-inflammation index


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