Fig. 2

COVID-19 symptom prevalence, somatic and neuropsychiatric assessments in hospitalized COVID-19 patients. (a) The prevalence of COVID-19 symptoms during hospitalization is categorized into low, moderate, and critical severity groups. The most common symptoms were fever (66%), cough (56%), and dyspnea (29%) which was more prevalent in the critical group (p < 0.001). The chi-square or Fisher’s exact test was used to analyze contingency tables. The median and interquartile range of the clinical outcomes results of the patients classified according to the COVID-19 Severity Index (n = 77). (b) Somatic symptoms (PHQ-15, Patient Health Questionnaire-15), (c) perception of stress (PSS, Perceived Stress Scale), (d) anxiety, and (e) depression (HADS-D, Hospital Anxiety and Depression Scale) scores were the same across the three groups categorized by COVID-19 severity (low, moderate, and critical). Pairwise comparisons between severity groups followed the Kruskal-Wallis test. Spearman’s Rank Correlation Coefficient showed a positive correlation between PHQ-15 scores and (f) PSS scores (r_s=0.347, p = 0.002), (g) HADS-A scores (r_s=0.475, p < 0.001) and (h) HADS-D scores (r_s=0.252, p = 0.027). These results indicate that a higher somatic symptom burden is associated with increased perceived stress, anxiety, and depressive symptoms in hospitalized COVID-19 patients. The concentrations (pg/ml) of (i) IL-6, (j) IL-12, and (k) IL-1ra were higher in the critical group compared to the low group. For (l) IFN-γ and (m) IL-10, the critical group showed higher levels than the low and moderate groups. The levels of (n) IP-10 were higher in the critical and moderate groups compared to the low group. Conversely, the levels of (o) PDGF-BB and (p) RANTES decreased from the low group to the critical group. For (q) IL-2, the critical group showed lower levels than the low and moderate groups. Pairwise comparisons between the severity groups followed the Kruskal-Wallis test. The lines and p-values indicate significant differences between these groups. Linear regression was used to compare variables with and without adjustment for age, gender, and BMI. Age influenced IFN-γ serum concentration. Both age and BMI affected the differences in IL-12 and RANTES levels. For the rest of the cytokines (IL-1ra, IL-2, IL-6, IL-10, IP-10, PDGF-BB), the factor responsible for the differences in concentrations was the severity of COVID-19. (r) Heatmap illustrating the correlations between various cytokine levels in serum concentration (% coefficient of variation) and somatic and neuropsychiatric symptoms scores in hospitalized COVID-19 patients, with significant correlations marked with asterisks (*p < 0.05, **p < 0.01, ***p < 0.001). Red shades represent positive correlations, whereas blue shades represent negative correlations. The Kruskal-Wallis test was followed by pairwise comparisons between severity groups with correction for multiple testing. IL, Interleukin; IL-1ra, Interleukin-1 receptor antagonist; IFN-γ, Interferon-gamma; IP-10, Interferon-gamma-inducible protein 10; PDGF-BB, Platelet-Derived Growth Factor BB; RANTES, Regulated on Activation, Normal T Cell Expressed and Secreted