Quality of life in hospitalized COVID-19 patients: The role of psychosocial, inflammatory, and dopaminergic pathways

Introduction: A significant proportion of COVID-19 survivors continues to suffer from persistent physical and psychological sequelae after hospital discharge.

Materials and methods: This cross-sectional study aimed to analyze the roles of psychosocial, inflammatory, and dopaminergic pathways in the relationship between posttraumatic stress symptoms (PTSS), rumination, and quality of life (QoL) in patients hospitalized with COVID-19, as well as the moderating role of time since discharge. A total of 207 participants were divided into two groups based on their discharge timing: those discharged 24 months prior (cohort I) and those discharged 6 to 12 months prior (cohort II). Data were collected at a single time point using validated measures of PTSS, rumination, psychological morbidity (anxiety and depression), loneliness, satisfaction with life, posttraumatic growth (PTG), and QoL.

Results: PTSS was positively associated with psychological morbidity and the expression of dopaminergic receptor (DR) D1 in peripheral blood mononuclear cells (PBMCs). Rumination was positively and strongly associated with PTG but negatively and weakly associated with satisfaction with life. Psychological morbidity was positively linked to loneliness and negatively associated with DRD1 expression in PBMCs and with physical and mental QoL. Several significant pathways were observed, particularly between PTSS and both QoL dimensions. The moderating role of time since discharge revealed significant differences, suggesting that psychosocial, inflammatory, and dopaminergic dynamics are more pronounced in patients from cohort II.

Discussion: This study underscores the complex interplay of psychosocial and neurobiological processes associated with long-term QoL, highlighting the need for a prompt biopsychosocial care approach to optimize recovery and health outcomes following COVID-19 infection.
The author(s) declared that financial support was received for this work and/or its publication. This study was conducted at CIPsi, School of Psychology, University of Minho, supported by the Portuguese Foundation for Science and Technology (FCT; UID/01662: Centro de Investigação em Psicologia) through national funds, and an FCT grant (PTDC/PSI-GER/2995/2021) assigned to the first author.