Endocannabinoids, endocannabinoid-like compounds and cortisone in head hair of health care workers as markers of stress and resilience during the early COVID-19 pandemic

Abstract

The pandemic caused by SARS-CoV-2 impacted health systems globally, creating increased workload and mental stress upon health care workers (HCW). During the first pandemic wave (March to May 2020) in southern Germany, we investigated the impact of stress and the resilience to stress in HCW by measuring changes in hair concentrations of endocannabinoids, endocannabinoid-like compounds and cortisone. HCW (n = 178) recruited from multiple occupation and worksites in the LMU-University-Hospital in Munich were interviewed at four interval visits to evaluate mental stress associated with the COVID-19 pandemic. A strand of hair of up to 6 cm in length was sampled once in May 2020, which enabled retrospective individual stress hormone quantifications during that aforementioned time period. Perceived anxiety and impact on mental health were demonstrated to be higher at the beginning of the COVID-19 pandemic and decreased significantly thereafter. Resilience was stable over time, but noted to be lower in women than in men. The concentrations of the endocannabinoid anandamide (AEA) and the structural congeners N-palmitoylethanolamide (PEA), N-oleoylethanolamide (OEA) and N-stearoylethanolamide (SEA) were noted to have decreased significantly over the course of the pandemic. In contrast, the endocannabinoid 2-arachidonoylglycerol (2-AG) levels increased significantly and were found to be higher in nurses, laboratory staff and hospital administration than in physicians. PEA was significantly higher in subjects with a higher resilience but lower in subjects with anxiety. SEA was also noted to be reduced in subjects with anxiety. Nurses had significantly higher cortisone levels than physicians, while female subjects had significant lower cortisone levels than males. Hair samples provided temporal and measurable objective psychophysiological-hormonal information. The hair endocannabinoids/endocannabinoid-like compounds and cortisone correlated to each other and to professions, age and sex quite differentially, relative to specific periods of the COVID-19 pandemic.

The role of hair endocannabinoid concentrations in clinical symptoms and treatment outcome in female inpatients with posttraumatic stress disorder

“…Initial research employing hair ECs/NAEs found reduced hair OEA levels in rebel war survivors with versus without PTSD as well as negative associations of hair NAE levels with number of traumatic events and PTSD symptom severity, respectively (Wilker et al, 2016). In community samples, hair EC/NAE levels were also negatively associated with burnout and anxiety symptoms (AEA; Gao et al, 2020), childbirth-related PTSD symptoms (AEA; Bergunde et al, 2023), and depressive symptoms (AEA; Walther et al, 2023) and reduced in health-care workers with anxiety (SEA and PEA; Biener et al, 2024), supporting an EC/NAE deficiency hypothesis in stress-related psychopathology. However, some studies found positive or no associations between hair ECs/NAEs and trauma and PTSD, or depressive, and anxiety symptoms (e.g., Behnke et al, 2021Behnke et al, , 2021Croissant et al, 2020), highlighting the need for further clarification.…”