{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T06:57:13Z","timestamp":1767769033665,"version":"3.48.0"},"reference-count":95,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T00:00:00Z","timestamp":1767744000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>A significant proportion of COVID-19 survivors continues to suffer from persistent physical and psychological sequelae after hospital discharge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>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\u202fmonths prior (cohort I) and those discharged 6 to 12\u202fmonths 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyg.2025.1684510","type":"journal-article","created":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T06:52:13Z","timestamp":1767768733000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Quality of life in hospitalized COVID-19 patients: the role of psychosocial, inflammatory, and dopaminergic pathways"],"prefix":"10.3389","volume":"16","author":[{"given":"M. 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Nurs. Res."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1111\/psyg.12312","article-title":"Low resilience to stress is associated with candidate gene expression alterations in the dopaminergic signaling pathway","volume":"18","author":"Azadmarzabadi","year":"2018","journal-title":"Psychogeriatrics"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"bhae214","DOI":"10.1093\/cercor\/bhae214","article-title":"Neural and psychological correlates of post-traumatic stress symptoms in a community adult sample","volume":"34","author":"Bainter","year":"2024","journal-title":"Cereb. Cortex"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1016\/j.pscychresns.2008.07.008","article-title":"Converging evidence for abnormalities of the prefrontal cortex and evaluation of midsagittal structures in pediatric posttraumatic stress disorder: an MRI study","volume":"172","author":"Carrion","year":"2009","journal-title":"Psychiatry Res. Neuroimaging"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1016\/j.bbi.2021.12.020","article-title":"Fatigue and cognitive impairment in post-COVID-19 syndrome: a systematic review and meta-analysis","volume":"101","author":"Ceban","year":"2022","journal-title":"Brain Behav. Immun."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1870","DOI":"10.1038\/s41386-020-0740-x","article-title":"The role of dopamine dysregulation and evidence for the transdiagnostic nature of elevated dopamine synthesis in psychosis: a positron emission tomography (PET) study comparing schizophrenia, delusional disorder, and other psychotic disorders","volume":"45","author":"Cheng","year":"2020","journal-title":"Neuropsychopharmacology"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1038\/s41398-020-00975-3","article-title":"L-DOPA and consolidation of fear extinction learning among women with posttraumatic stress disorder","volume":"10","author":"Cisler","year":"2020","journal-title":"Transl. Psychiatry"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1007\/s11481-012-9410-z","article-title":"Adrenergic and dopaminergic modulation of immunity in multiple sclerosis: teaching old drugs new tricks?","volume":"8","author":"Cosentino","year":"2013","journal-title":"J. Neuroimmune Pharmacol."},{"key":"ref9","doi-asserted-by":"publisher","first-page":"05051","DOI":"10.7189\/jogh.12.05051","article-title":"Telemedicine and health access inequalities during the COVID-19 pandemic","volume":"12","author":"Datta","year":"2022","journal-title":"J. Glob. Health"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"697","DOI":"10.1080\/13548506.2024.2433542","article-title":"Posttraumatic stress symptoms and rumination: the moderator effect of time","volume":"30","author":"Di Tella","year":"2025","journal-title":"Psychol. Health Med."},{"key":"ref11","doi-asserted-by":"publisher","first-page":"113425","DOI":"10.1016\/j.socscimed.2020.113425","article-title":"COVID-19-related stigma profiles and risk factors among people who are at high risk of contagion","volume":"266","author":"Duan","year":"2020","journal-title":"Soc. Sci. Med."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1016\/j.stem.2024.01.002.","article-title":"Unraveling the brain\u2019s response to COVID-19: how SARS-CoV-2 afflicts dopaminergic neurons","volume":"31","author":"Eidhof","year":"2024","journal-title":"Cell Stem Cell"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"102756","DOI":"10.1016\/j.eclinm.2024.102756","article-title":"Psychological factors associated with long COVID: a systematic review and meta-analysis","volume":"74","author":"Engelmann","year":"2024","journal-title":"EClinicalMedicine"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"871","DOI":"10.1016\/j.biopsych.2015.04.024","article-title":"Anhedonia, reduced cocaine reward, and dopamine dysfunction in a rat model of posttraumatic stress disorder","volume":"78","author":"Enman","year":"2015","journal-title":"Biol. Psychiatry"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1275","DOI":"10.1016\/S2213-2600(21)00383-0","article-title":"Physical, cognitive, and mental health impacts of COVID-19 after hospitalisation (PHOSP-COVID): a UK multicentre, prospective cohort study","volume":"9","author":"Evans","year":"2021","journal-title":"Lancet Respir. Med."},{"key":"ref16","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1007\/s12646-019-00483-5","article-title":"Psychometric and rash analysis of the UCLA loneliness scale-16 in a Portuguese sample of older adults","volume":"64","author":"Faustino","year":"2019","journal-title":"Psychol. Stud."},{"key":"ref17","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1016\/j.rpsp.2012.12.007","article-title":"Medidas sum\u00e1rio f\u00edsica e mental de estado de sa\u00fade para a popula\u00e7\u00e3o portuguesa. (Physical and mental summary measures of health state for the portuguese population)","volume":"30","author":"Ferreira","year":"2012","journal-title":"Rev. Port. Saude Publica"},{"key":"ref18","author":"Fillion","year":"2024"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1822","DOI":"10.1038\/s41591-019-0675-0","article-title":"Chronic inflammation in the etiology of disease across the life span","volume":"25","author":"Furman","year":"2019","journal-title":"Nat. Med."},{"key":"ref20","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1097\/PSY.0000000000001146","article-title":"The association of age with depression, anxiety, and posttraumatic stress symptoms during the COVID-19 pandemic in Spain: the role of loneliness and prepandemic mental disorder","volume":"85","author":"Gabarrell-Pascuet","year":"2023","journal-title":"Psychosom. Med."},{"key":"ref21","doi-asserted-by":"publisher","first-page":"e4","DOI":"10.1016\/j.jinf.2020.08.029","article-title":"Post-discharge persistent symptoms and health-related quality of life after hospitalization for COVID-19","volume":"81","author":"Garrigues","year":"2020","journal-title":"J. Infect."},{"key":"ref22","doi-asserted-by":"publisher","first-page":"102626","DOI":"10.1016\/j.conb.2022.102626","article-title":"Dopamine and norepinephrine are embracing their immune side and so should we","volume":"77","author":"Gaskill","year":"2022","journal-title":"Curr. Opin. Neurobiol."},{"key":"ref23","doi-asserted-by":"publisher","first-page":"2272477","DOI":"10.1080\/20008066.2023.2272477","article-title":"Posttraumatic growth EEG neuromarkers: translational neural comparisons with resilience and PTSD in trauma-exposed healthy adults","volume":"14","author":"Glazebrook","year":"2023","journal-title":"Eur. J. Psychotraumatol."},{"key":"ref24","volume-title":"Multivariate data analysis","author":"Hair","year":"2010"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1111\/j.1468-5884.2011.00460.x","article-title":"Life satisfaction and inflammatory biomarkers: the 2008 Scottish health survey 1","volume":"53","author":"Hamer","year":"2011","journal-title":"Jpn. Psychol. Res."},{"key":"ref26","doi-asserted-by":"publisher","first-page":"269","DOI":"10.3390\/pathogens11020269","article-title":"Long-term sequelae of COVID-19: a systematic review and meta-analysis of one-year follow-up studies on post-COVID symptoms","volume":"11","author":"Han","year":"2022","journal-title":"Pathogens"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1016\/j.ajem.2020.12.076","article-title":"Inflammatory and hematologic markers as predictors of severe outcomes in COVID-19 infection: a systematic review and meta-analysis","volume":"41","author":"Hariyanto","year":"2021","journal-title":"Am. J. Emerg. Med."},{"key":"ref28","doi-asserted-by":"publisher","first-page":"578","DOI":"10.3390\/ijms24010578","article-title":"Selected biomarkers of depression: what are the effects of cytokines and inflammation?","volume":"24","author":"Harsanyi","year":"2023","journal-title":"Int. J. Mol. Sci."},{"key":"ref29","doi-asserted-by":"publisher","first-page":"1130989","DOI":"10.3389\/fpsyt.2023.1130989","article-title":"Chronic stress, neuroinflammation, and depression: an overview of pathophysiological mechanisms and emerging anti-inflammatories","volume":"14","author":"Hassamal","year":"2023","journal-title":"Front. Psych."},{"key":"ref30","volume-title":"Introduction to mediation, moderation, and conditional process analysis: a regression-based approach","author":"Hayes","year":"2018"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1016\/S0140-6736(23)00810-3","article-title":"6-month consequences of COVID-19 in patients discharged from hospital: a cohort study","volume":"401","author":"Huang","year":"2023","journal-title":"Lancet"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"747","DOI":"10.1016\/S0140-6736(21)01755-4","article-title":"1-year outcomes in hospital survivors with COVID-19: a longitudinal cohort study","volume":"398","author":"Huang","year":"2021","journal-title":"Lancet"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"157","DOI":"10.3390\/biomedicines9020157","article-title":"Early adolescence prefrontal cortex alterations in female rats lacking dopamine transporter","volume":"9","author":"Illiano","year":"2021","journal-title":"Biomedicine"},{"key":"ref1101","doi-asserted-by":"publisher","first-page":"1011","DOI":"10.12740\/PP\/152817","article-title":"Ruminations as predictors of post-traumatic stress disorder after hospitalization for Covid-19. Ruminacje jako wyznaczniki zespo\u0142u stresu pourazowego po hospitalizacji z powodu Covid-19","volume":"57","author":"Juczy\u0144ski","year":"2023","journal-title":"Psychiatr. Pol."},{"key":"ref34","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1037\/tra0000995","article-title":"Mindfulness as a mediator between trauma exposure and mental health outcomes: results from the National Health and resilience in veterans study","volume":"13","author":"Kachadourian","year":"2021","journal-title":"Psychol. Trauma Theory Res. Pract. Policy"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"21501319231206911","DOI":"10.1177\/21501319231206911","article-title":"COVID-19 infections and inflammatory markers in patients hospitalized during the first year of the pandemic","volume":"14","author":"Kalaiselvan","year":"2023","journal-title":"J. Prim. Care Community Health"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1080\/13651501.2021.1993924","article-title":"Meta-analysis of prevalence: the psychological sequelae among COVID-19 survivors","volume":"26","author":"Khraisat","year":"2022","journal-title":"Int. J. Psychiatry Clin. Pract."},{"key":"ref37","doi-asserted-by":"publisher","first-page":"e284","DOI":"10.3346\/jkms.2018.33.e284","article-title":"Mediating role of anxiety and depression in the relationship between posttraumatic stress symptoms and illness intrusiveness","volume":"33","author":"Kim","year":"2018","journal-title":"J. Korean Med. Sci."},{"key":"ref38","volume-title":"Principles and practice of structural equation modeling","author":"Kline","year":"2015"},{"key":"ref39","doi-asserted-by":"publisher","DOI":"10.1037\/t28139-000","article-title":"Posttraumatic growth inventory short form\u2014Portuguese version (Portuguese PTGI-SF, PTGI-SF) [database record]","author":"Lamela","year":"2013","journal-title":"APA PsycTests"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"2486","DOI":"10.1093\/cercor\/bhr326","article-title":"Dopamine D4 receptor transmission in the prefrontal cortex controls the salience of emotional memory via modulation of calcium calmodulin-dependent kinase II","volume":"22","author":"Lauzon","year":"2012","journal-title":"Cereb. Cortex"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1016\/j.neuropharm.2012.10.029","article-title":"Supra-normal stimulation of dopamine D1 receptors in the prelimbic cortex blocks behavioral expression of both aversive and rewarding associative memories through a cyclic-AMP-dependent signaling pathway","volume":"67","author":"Lauzon","year":"2013","journal-title":"Neuropharmacology"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"727","DOI":"10.1016\/j.jad.2024.09.113","article-title":"Post-traumatic growth promotes resilience development: a longitudinal mediation model","volume":"368","author":"Li","year":"2025","journal-title":"J. Affect. Disord."},{"key":"ref43","doi-asserted-by":"publisher","first-page":"1691","DOI":"10.3390\/cells11101691","article-title":"Dopamine reduces SARS-CoV-2 replication in vitro through downregulation of D2 receptors and upregulation of type-I interferons","volume":"11","author":"Limanaqi","year":"2022","journal-title":"Cells"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"102266","DOI":"10.1016\/j.pmedr.2023.102266","article-title":"Relationship between rumination and post-traumatic growth in mobile cabin hospital nurses: the mediating role of psychological resilience","volume":"34","author":"Liu","year":"2023","journal-title":"Prev. Med. Rep."},{"key":"ref45","doi-asserted-by":"publisher","first-page":"3708","DOI":"10.1007\/s12035-023-03312-z","article-title":"Insights into the involvement and therapeutic target potential of the dopamine system in posttraumatic stress disorder","volume":"60","author":"Liu","year":"2023","journal-title":"Mol. Neurobiol."},{"key":"ref47","doi-asserted-by":"publisher","first-page":"e6","DOI":"10.1016\/j.jinf.2020.04.002","article-title":"Neutrophil-to-lymphocyte ratio as an independent risk factor for mortality in hospitalized patients with COVID-19","volume":"81","author":"Liu","year":"2020","journal-title":"J. Infect."},{"key":"ref48","author":"Lopes","year":"2013"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"901","DOI":"10.1080\/03007995.2022.2042991","article-title":"Post-COVID-19 syndrome, low-grade inflammation and inflammatory markers: a cross-sectional study","volume":"38","author":"Maamar","year":"2022","journal-title":"Curr. Med. Res. Opin."},{"key":"ref50","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1186\/s12912-022-00958-3","article-title":"The mediating role of life satisfaction in the relationship between depression, anxiety, stress and burnout among Portuguese nurses during COVID-19 pandemic","volume":"21","author":"Martins","year":"2022","journal-title":"BMC Nurs."},{"key":"ref51","doi-asserted-by":"publisher","first-page":"594","DOI":"10.1016\/j.bbi.2020.07.037","article-title":"Anxiety and depression in COVID-19 survivors: role of inflammatory and clinical predictors","volume":"89","author":"Mazza","year":"2020","journal-title":"Brain Behav. Immun."},{"key":"ref52","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1016\/s0165-5728(02)00280-1","article-title":"Dopamine receptor expression on human T- and B-lymphocytes, monocytes, neutrophils, eosinophils and NK cells: a flow cytometric study","volume":"132","author":"McKenna","year":"2002","journal-title":"J. Neuroimmunol."},{"key":"ref53","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1038\/npp.2016.146","article-title":"Inflammation in fear- and anxiety-based disorders: PTSD, GAD, and beyond","volume":"42","author":"Michopoulos","year":"2017","journal-title":"Neuropsychopharmacology"},{"key":"ref54","doi-asserted-by":"publisher","first-page":"1460097","DOI":"10.3389\/fpsyt.2025.1460097","article-title":"Course of neuropsychological health in post-COVID patients differs 6 and 12 months after inpatient rehabilitation","volume":"16","author":"M\u00fcller","year":"2025","journal-title":"Front. Psych."},{"key":"ref55","year":"2020"},{"key":"ref56","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1186\/s12955-016-0452-4","article-title":"Mediation analysis of relationships between chronic inflammation and quality of life in older adults","volume":"14","author":"Nowakowski","year":"2016","journal-title":"Health Qual. Life Outcomes"},{"key":"ref57","doi-asserted-by":"publisher","first-page":"1122","DOI":"10.1080\/09638237.2022.2069716","article-title":"Effects of COVID-19-related worry and rumination on mental health and loneliness during the pandemic: longitudinal analyses of adults in the UK COVID-19 mental health & wellbeing study","volume":"32","author":"O\u2019Connor","year":"2022","journal-title":"J. Ment. Health"},{"key":"ref58","doi-asserted-by":"publisher","first-page":"103274","DOI":"10.1016\/j.iccn.2022.103274","article-title":"The examination of stress symptoms and posttraumatic growth in the patients diagnosed with COVID-19","volume":"73","author":"\u00d6zg\u00fc\u00e7","year":"2022","journal-title":"Intensive Crit. Care Nurs."},{"key":"ref59","doi-asserted-by":"publisher","first-page":"117","DOI":"10.3389\/fimmu.2014.00117","article-title":"The dopaminergic system in autoimmune diseases","volume":"5","author":"Pacheco","year":"2014","journal-title":"Front. Immunol."},{"key":"ref60","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1080\/13548500500524088","article-title":"Validation study of a Portuguese version of the hospital anxiety and depression scale","volume":"12","author":"Pais-Ribeiro","year":"2007","journal-title":"Psychol. Health Med."},{"key":"ref61","doi-asserted-by":"publisher","first-page":"2580","DOI":"10.3390\/ijms23052580","article-title":"Biomarkers in human peripheral blood mononuclear cells: the state of the art in amyotrophic lateral sclerosis","volume":"23","author":"Pansarasa","year":"2022","journal-title":"Int. J. Mol. Sci."},{"key":"ref62","doi-asserted-by":"publisher","first-page":"2027","DOI":"10.1038\/s41591-022-02028-2","article-title":"How COVID-19 shaped mental health: from infection to pandemic effects","volume":"28","author":"Penninx","year":"2022","journal-title":"Nat. Med."},{"key":"ref63","doi-asserted-by":"publisher","first-page":"21m14277","DOI":"10.4088\/JCP.21m14277","article-title":"Factors associated with posttraumatic stress symptoms 3 and 6 months after hospitalization for COVID-19: a longitudinal multicenter study","volume":"84","author":"Pitron","year":"2022","journal-title":"J. Clin. Psychiatry"},{"key":"ref64","doi-asserted-by":"publisher","first-page":"e70429","DOI":"10.1002\/jmv.70429","article-title":"Long-term sequelae of COVID-19: a systematic review and meta-analysis of symptoms 3 years post-SARS-CoV-2 infection","volume":"97","author":"Rahmati","year":"2025","journal-title":"J. Med. Virol."},{"key":"ref65","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1007\/978-1-4939-7614-0_12","article-title":"Studies of isolated peripheral blood cells as a model of immune dysfunction","volume-title":"Investigations of early nutrition effects on long-term health: methods and applications","author":"Rahmoune","year":"2018"},{"key":"ref66","doi-asserted-by":"publisher","first-page":"299","DOI":"10.15309\/15psd160303","article-title":"Invent\u00e1rio de rumina\u00e7\u00e3o relacionada com o acontecimento: qualidades psicom\u00e9tricas na popula\u00e7\u00e3o portuguesa. (Event-related rumination inventory: psychometric properties on a Portuguese sample)","volume":"16","author":"Ramos","year":"2015","journal-title":"Psic. Sa\u00fade Doen\u00e7as"},{"key":"ref67","doi-asserted-by":"publisher","first-page":"e2506","DOI":"10.1002\/rmv.2506","article-title":"Assessment of the relationship between the dopaminergic pathway and severe acute respiratory syndrome coronavirus 2 infection, with related neuropathological features, and potential therapeutic approaches in COVID-19 infection","volume":"34","author":"Rasmi","year":"2024","journal-title":"Rev. Med. Virol."},{"key":"ref68","doi-asserted-by":"publisher","first-page":"100397","DOI":"10.1016\/j.bbih.2021.100397","article-title":"A review and novel theoretical model of how negative emotions influence inflammation: the critical role of emotion regulation","volume":"18","author":"Renna","year":"2021","journal-title":"Brain Behav. Immun. Health"},{"key":"ref69","doi-asserted-by":"publisher","first-page":"15","DOI":"10.17979\/reipe.2019.6.1.4617","article-title":"Escala de Satisfa\u00e7\u00e3o com a Vida: Evid\u00eancias de validade e precis\u00e3o junto de universit\u00e1rios portugueses. (Satisfaction with Life Scale: Evidences of validity and reliability among portuguese college students)","volume":"6","author":"Reppold","year":"2019","journal-title":"Rev. Estud. Investig. Psicol. Educ."},{"key":"ref70","doi-asserted-by":"publisher","first-page":"435","DOI":"10.3390\/microorganisms12030435","article-title":"A real-world nationwide study on COVID-19 trend in Italy during the autumn\u2013winter season of 2020 (before mass vaccination) and 2021 (after mass vaccination) integrated with a retrospective analysis of the mortality burden per year","volume":"12","author":"Roncati","year":"2024","journal-title":"Microorganisms"},{"key":"ref71","doi-asserted-by":"publisher","first-page":"4330","DOI":"10.3390\/ijms25084330","article-title":"Experimental models to study immune dysfunction in the pathogenesis of Parkinson\u2019s disease","volume":"25","author":"Saponjic","year":"2024","journal-title":"Int. J. Mol. Sci."},{"key":"ref72","doi-asserted-by":"publisher","first-page":"525","DOI":"10.1016\/j.bbi.2009.10.015","article-title":"The immunoregulatory role of dopamine: an update","volume":"24","author":"Sarkar","year":"2010","journal-title":"Brain Behav. Immun."},{"key":"ref73","doi-asserted-by":"publisher","first-page":"1296385","DOI":"10.3389\/fpsyt.2023.1296385","article-title":"The sense of loneliness and meaning in life in post-COVID convalescents-a preliminary study","volume":"14","author":"Sipowicz","year":"2023","journal-title":"Front. Psych."},{"key":"ref74","author":"Soper","year":"2019"},{"key":"ref75","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1016\/j.jad.2020.08.040","article-title":"Qualitative study of the psychological experience of COVID-19 patients during hospitalization","volume":"278","author":"Sun","year":"2021","journal-title":"J. Affect. Disord."},{"key":"ref76","doi-asserted-by":"publisher","first-page":"104523","DOI":"10.1016\/j.neubiorev.2022.104523","article-title":"Understanding associations between rumination and inflammation: a scoping review","volume":"135","author":"Szabo","year":"2022","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref77","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1207\/s15327965pli1501_01","article-title":"Posttraumatic growth: conceptual foundations and empirical evidence","volume":"15","author":"Tedeschi","year":"2004","journal-title":"Psychol. 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Neuroinflammation"},{"key":"ref86","year":"2024"},{"key":"ref87","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1016\/j.cell.2014.11.047","article-title":"Dopamine controls systemic inflammation through inhibition of NLRP3 inflammasome","volume":"160","author":"Yan","year":"2015","journal-title":"Cell"},{"key":"ref88","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1016\/j.jad.2020.02.044","article-title":"Immune biomarker alterations in post-traumatic stress disorder: a systematic review and meta-analysis","volume":"268","author":"Yang","year":"2020","journal-title":"J. Affect. Disord."},{"key":"ref89","doi-asserted-by":"publisher","first-page":"e2231790","DOI":"10.1001\/jamanetworkopen.2022.31790","article-title":"Two-year health outcomes in hospitalized COVID-19 survivors in China","volume":"5","author":"Yang","year":"2022","journal-title":"JAMA Netw. Open"},{"key":"ref90","doi-asserted-by":"publisher","first-page":"966","DOI":"10.1186\/s12888-024-06439-y","article-title":"Neutrophil-to-lymphocyte, platelet-to-lymphocyte ratios and systemic immune-inflammation index in patients with post-traumatic stress disorder","volume":"24","author":"Yontar","year":"2024","journal-title":"BMC Psychiatry"},{"key":"ref91","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1016\/j.expneurol.2008.08.015","article-title":"Therapy with interferon-\u03b2 modulates endogenous catecholamines in lymphocytes of patients with multiple sclerosis","volume":"214","author":"Zaffaroni","year":"2008","journal-title":"Exp. Neurol."},{"key":"ref92","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1016\/j.jad.2024.04.072","article-title":"Inflammation as a mediator between adverse childhood experiences and adult depression: a meta-analytic structural equation model","volume":"357","author":"Zagaria","year":"2024","journal-title":"J. Affect. 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