the role of anxiety and cortisol in outcomes of patients with covid-19

Introduction: the outbreak due to coronavirus disease 2019 (covid-19) is n global public health emergency and challenges psychological resilience. the central nervous system, endocrine system, and immune system are complex interacting systems. cortisol has been implicated as the cause of a wide range of mental and physical health disorders; however, the impact of cortisol on outcomes in patients with covid-19 is not clear. methods: the current study enrolled patients with covid-19 (onset of disease within 7 days of the first symptom) to evaluate the serum concentration of cortisol and levels of anxiety and depression using the hospital anxiety and depression scale (hads) to investigate a possible relationship between cortisol, depression, and anxiety levels and outcomes of patients with covid-19. results: a total of 30 patients with covid-19 were studied. the levels of cortisol and hads score in patients who died of covid-19 were significantly higher in comparison with surviving patients (p<0.017 and p<0.001 respectively). we also found that the hads score was positively correlated with serum cortisol levels (r= 0.842, p=0.004). conclusion: our findings showed that stress and anxiety are associated with patients’ outcomes. psychological interventions can improve the mental health of vulnerable groups during the covid-19 epidemic.