The role of overgeneralized autobiographical memories and inflammatory markers in stress symptoms associated with the COVID-19 pandemic

Objective To investigate the characteristics of pandemic-related stress symptoms among frontline healthcare workers involved in COVID-19 prevention and control, as well as the roles of overgeneralized autobiographical memory (OGM) and inflammatory markers in these symptoms. Methods Using convenience sampling, 52 frontline healthcare workers (exposure group) and 55 non-frontline healthcare workers (control group) who participated in COVID-19 prevention and control efforts at the Guannan Campus of Lianyungang First People’s Hospital between March 2020 and March were selected.Assessments were conducted using the Posttraumatic Stress Disorder Checklist (PCL-C), the Autobiographical Memory Test (AMT), and the Childhood Trauma Questionnaire (CTQ), and serum levels of IL-1β, IL-2, IL-6, IL-8, IL-18, and C-reactive protein (CRP) were measured.Statistical analyses were performed using the Mann-Whitney U test, Spearman’s rank correlation, and bootstrap stratified regression analysis. Results In the exposure group, significant differences compared to the control group were observed in PCL-C avoidance (Z = −1.984, P = 0.047), hypervigilance (Z = −2.020, P = 0.043), OGM total score (Z = −4.379, P < 0.001), IL-1β (Z = −2.029, P = 0.042), and CRP (Z = −2.605, P = 0.009), but not for the PCL-C total score, re-experiencing dimension, or IL-18. Both PCL-C avoidance and vigilance were positively correlated with the OGM total score (r = 0.447, P < 0.01) and CRP (r = 0.698, P < 0.01), but not with IL-1β (P > 0.05). Stratified regression showed significant associations of OGM total score and CRP with PCL-C vigilance (β = 0.299, P = 0.005; β = 0.587, P < 0.001) and avoidance (β = 0.302, P = 0.006; β = 0.660, P < 0.001), while IL-1β correlation was not significant (P > 0.05). Conclusion Frontline healthcare workers during the COVID-19 pandemic showed higher stress symptoms and elevated inflammatory markers, OGM and CRP, compared to a control group. OGM and CRP were linked to pandemic-related stress, while IL-1β, although elevated, lacked independent predictive power. CRP showed the strongest correlation with stress symptoms, suggesting it could be a key biological marker for understanding pandemic-related stress.