Frida Ayu Nur Hayati and Margarita Maria Maramis and Atika and Menina Vilanova Syamsuri (2021) The effect of anxiety, depression, and stress on the immune response of Covid-19 patients treated in a special isolation room of dr. Soetomo Hospital Surabaya. International Journal of Research Publications (IJRP.ORG), 101 (1). pp. 40-53. ISSN 2708-3578

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Abstract

Abstract Background: SARS-CoV-2 infection causes anxiety, depression, and stress that affect the immune response. Objective: This study aims to analyze the effect of anxiety, depression, and stress on the Neutrophil-Lymphocyte Ratio (NLR) and Interleukin 1 beta (IL-1?) of Covid-19 patients. Method: Analytical observational research with consecutive sampling technique. The inclusion criteria were new patients with a confirmed COVID-19 diagnosis, treated at Dr. Soetomo Hospital Surabaya, aged 21 ? 60 years, does not have a severe mental disorder, can communicate verbally and is able to answer questionnaires. Measurements of anxiety, depression and stress (DASS-21), NLR, IL-1? were performed while the patient was admitted on days 0th, 6th, and 12th. Spearman correlation test analysis to assess the relationship between DASS-21 scores and NLR and IL-1? scores, Mc Nemar's test comparison to assess differences in depression and stress on days 0th and 6th, Wilcoxon's signed rank test for differences in anxiety and IL-1? on days 0th and 6th, and paired t-test to assess differences in NLR on days 0th and 6th. As well as multivariate analysis to assess the effect of anxiety, depression, and stress on NLR and IL-1?. Results: From 38 research subjects, there were 29 subjects who dropped out after the 6th day, 28 subjects experienced clinical improvement and underwent self-isolation at home, and 1 subject experienced worsening of symptoms so that it was difficult to conduct interviews. Most of the subjects (95%) had anxiety scores ranging from mild to very severe on day 0th of treatment, but most had normal depression scores (86.8%), and normal stress scores (92.1%). There were differences in anxiety scores (0.016), and IL-1? levels (p=0.001) on the 6th day. There were no differences in depression, stress, and NLR scores during the observation period 0th and 6th. In the multivariate analysis, there was no significant effect of anxiety, depression, and stress on NLR. Anxiety had an effect on IL-1? on the 6th day of observation, with p=0.030; OR(95%CI) = 0.853 (0.738 ? 0.985). Conclusion: Anxiety affected IL-1? levels in mild-moderate COVID-19 patients on day 6th, but had no effect on NLR on days 0th and 6th. Depression and stress had no effect on NLR or IL-1? of mild-moderate COVID-19 patients on days 0th and 6th.

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