ORIGINAL RESEARCH article
Front. Psychol.
Sec. Health Psychology
This article is part of the Research TopicHealth and Psychological Adaptations to Life Challenges and Stressful Conditions - Volume IIView all 16 articles
Quality of Life in Hospitalized COVID-19 Patients: The Role of Psychosocial, Inflammatory, and Dopaminergic Pathways
Provisionally accepted
M.Graça Pereira1*
Margarida Vilaça1
Martim Santos1
Sandra Carvalho1
Jorge Leite2
André Santos Silva3
Marco Cosentino4
Franca Marino4
Massimiliano Legnaro4
Fernanda Leite3- 1University of Minho, Braga, Portugal
- 2Universidade Portucalense Infante Dom Henrique, Porto, Portugal
- 3Centro Hospitalar Universitario de Santo Antonio, Porto, Portugal
- 4Universita degli Studi dell'Insubria, Varese, Italy
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Introduction: A significant proportion of COVID-19 survivors continue to suffer persistent physical and psychological sequelae after hospital discharge. Methods: This cross-sectional study aimed to analyze the role 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 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.
Keywords: COVID-19 patients, posttraumatic stress, rumination, Inflammation, dopaminergicexpression, Psychological morbidity, Quality of Life
Received: 12 Aug 2025; Accepted: 25 Nov 2025.
Copyright: © 2025 Pereira, Vilaça, Santos, Carvalho, Leite, Silva, Cosentino, Marino, Legnaro and Leite. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: M.Graça Pereira
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