Impact of Elevated Body Mass Index (BMI) on Hedonic Tone in Persons with Post-COVID-19 Condition: A Secondary Analysis

Gia Han Le; Angela T H Kwan; Sabrina Wong; Ziji Guo; Kayla M Teopiz; Sebastian Badulescu; Shakila Meshkat; Giacomo d'Andrea; Roger Ho; Taeho Greg Rhee; Bing Cao; Lee Phan; Joshua D Rosenblat; Rodrigo B Mansur; Mehala Subramaniapillai; Roger S McIntyre

doi:10.1007/s12325-023-02760-2

Impact of Elevated Body Mass Index (BMI) on Hedonic Tone in Persons with Post-COVID-19 Condition: A Secondary Analysis

Adv Ther. 2024 Feb;41(2):686-695. doi: 10.1007/s12325-023-02760-2. Epub 2023 Dec 19.

Authors

Gia Han Le^{1

2}, Angela T H Kwan^{1

3}, Sabrina Wong^{1

4}, Ziji Guo^{1

4}, Kayla M Teopiz¹, Sebastian Badulescu^{1

2}, Shakila Meshkat¹, Giacomo d'Andrea⁵, Roger Ho^{6

7}, Taeho Greg Rhee^{8

9}, Bing Cao¹⁰, Lee Phan¹, Joshua D Rosenblat^{2

4

11}, Rodrigo B Mansur^{1

2}, Mehala Subramaniapillai¹, Roger S McIntyre^{12

13

14}

Affiliations

¹ Brain and Cognition Discovery Foundation, 77 Bloor Street West, Suite 617, Toronto, ON, M5S 1M2, Canada.
² Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
³ Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
⁴ Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada.
⁵ Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University, Chieti, Italy.
⁶ Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
⁷ Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, Singapore.
⁸ Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.
⁹ Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT, USA.
¹⁰ Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, 400715, People's Republic of China.
¹¹ Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
¹² Brain and Cognition Discovery Foundation, 77 Bloor Street West, Suite 617, Toronto, ON, M5S 1M2, Canada. roger.mcintyre@bcdf.org.
¹³ Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada. roger.mcintyre@bcdf.org.
¹⁴ Department of Psychiatry, University of Toronto, Toronto, ON, Canada. roger.mcintyre@bcdf.org.

PMID: 38114867
DOI: 10.1007/s12325-023-02760-2

Abstract

Introduction: The post-COVID-19 condition (PCC) is characterized by persistent, distressing symptoms following an acute COVID-19 infection. These symptoms encompass various domains, including hedonic tone, which is critical for overall well-being. Furthermore, obesity is both a risk factor for COVID-19 and PCC and associated with impaired hedonic tone. This study aims to investigate whether elevated body mass index (BMI) is associated with hedonic tone in persons with PCC.

Methods: We perform a post hoc analysis of a randomized, double-blind, placebo-controlled clinical trial investigating the impact of vortioxetine on cognitive impairment in persons with PCC. Statistical analysis of baseline data using a generalized linear model was undertaken to determine the relationship of BMI to hedonic tone measured by Snaith-Hamilton Pleasure Scale (SHAPS) scores. The model was adjusted for covariates including age, sex, race, suspected versus confirmed COVID-19 cases, alcohol amount consumed per week, and annual household income.

Results: The baseline data of 147 participants were available for analysis. BMI had a statistically significant positive association with baseline SHAPS total scores (β = 0.003, 95% CI [6.251E-5, 0.006], p = 0.045), indicating elevated BMI is associated with deficits in self-reported reward system functioning.

Conclusion: Higher BMI is associated with greater deficits in hedonic tone in persons with PCC, which may impact reward functioning processes such as reward prediction and processing. The mediatory effect of BMI on reward function underscores the need to investigate the neurobiologic interactions to elucidate preventative and therapeutic interventions for persons with PCC. Therapeutic development targeting debilitating features of PCC (e.g., motivation, cognitive dysfunction) could consider stratification on the basis of baseline BMI.

Trial registration number: NCT05047952.

Keywords: BMI; Hedonic tone; Long COVID; PCC; Post-COVID condition; Post-COVID-19.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Body Mass Index
COVID-19* / complications
Humans
Infant
Obesity / complications
Pleasure
Self Report

Associated data

ClinicalTrials.gov/NCT05047952