Psychosocial Vulnerabilities to Upper Respiratory Infectious Illness: Implications for Susceptibility to Coronavirus Disease 2019 (COVID-19)

Cohen, Sheldon

doi:10.1177/1745691620942516

Cited by 100 publications

(90 citation statements)

References 71 publications

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“…Several experimental studies suggest a dose-dependent association between psychological stress and acute infectious respiratory illness. 4 , 21 , 22 Similarly, studies using large population-based registers 5 , 23 have shown an association between psychiatric disorders, especially stress-related disorder, and subsequent severe infections in the general population. Recent studies have examined these associations in the context of the COVID-19 pandemic, indicating that a range of psychosocial factors, 11 including self-reported symptoms of psychological distress, and certain psychiatric disorders (depression, 12 substance use, and schizophrenia 13 ) were associated with an increased risk of COVID-19.…”

Section: Discussionmentioning

confidence: 98%

Pre-pandemic psychiatric disorders and risk of COVID-19: a UK Biobank cohort analysis

Yang

Chen

et al. 2020

The Lancet Healthy Longevity

107

136

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Background Psychiatric morbidities have been associated with a risk of severe infections through compromised immunity, health behaviours, or both. However, data are scarce on the association between multiple types of pre-pandemic psychiatric disorders and COVID-19. We aimed to assess the association between pre-pandemic psychiatric disorders and the subsequent risk of COVID-19 using UK Biobank. Methods For this cohort analysis, we included participants from UK Biobank who were registered in England and excluded individuals who died before Jan 31, 2020, (the start of the COVID-19 outbreak in the UK) or had withdrawn from UK Biobank. Participants diagnosed with a psychiatric disorder before Jan 31 were included in the group of individuals with pre-pandemic psychiatric disorders, whereas participants without a diagnosis before the outbreak were included in the group of individuals without pre-pandemic psychiatric disorders. We used the Public Health England dataset, UK Biobank hospital data, and death registers to collect data on COVID-19 cases. To examine the relationship between pre-pandemic psychiatric disorders and susceptibility to COVID-19, we used logistic regression models to estimate odds ratios (ORs), controlling for multiple confounders and somatic comorbidities. Key outcomes were all COVID-19, COVID-19 specifically diagnosed in inpatient care, and COVID-19-related deaths. ORs were also estimated separately for each psychiatric disorder and on the basis of the number of pre-pandemic psychiatric disorders. As a positive disease control, we repeated analyses for hospitalisation for other infections. Findings We included 421 014 UK Biobank participants in our study and assessed their COVID-19 status between Jan 31 and July 26, 2020. 50 809 participants were diagnosed with psychiatric disorders before the outbreak, while 370 205 participants had no psychiatric disorders. The mean age at outbreak was 67·80 years (SD 8·12). We observed an elevated risk of COVID-19 among individuals with pre-pandemic psychiatric disorders compared with that of individuals without such conditions. The fully adjusted ORs were 1·44 (95% CI 1·28–1·62) for All COVID-19 cases, 1·55 (1·34–1·78) for Inpatient COVID-19 cases, and 2·03 (1·59–2·59) for COVID-19-related deaths. We observed excess risk, defined as risk that increased with the number of pre-pandemic psychiatric disorders, across all diagnostic categories of pre-pandemic psychiatric disorders. We also observed an association between psychiatric disorders and elevated risk of hospitalisation due to other infections (OR 1·74, 95% CI 1·58–1·93). Interpretation Our findings suggest that pre-existing psychiatric disorders are associated with an increased risk of COVID-19. These findings underscore the need for surveillance of and care for populations with pre-existing psychiatric disorders during the COVID-19 pandemic. Funding National Natural Science...

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Section: Discussionmentioning

confidence: 98%

Pre-pandemic psychiatric disorders and risk of COVID-19: a UK Biobank cohort analysis

Yang

Chen

et al. 2020

The Lancet Healthy Longevity

107

136

View full text Add to dashboard Cite

show abstract

“…Further study of factors that promote resilience in the context of COVID-19 pregnancies could also lead to the development of interventions. Additionally, the influence of stress on infection and inflammatory processes highlights a need to investigate the interaction of pandemic-related perinatal stress with COVID-19 infection ( Acabchuk et al, 2017 ; Cohen, 2020 ; Simons et al, 2017 ).…”

Section: Discussionmentioning

confidence: 99%

Vulnerability and resilience to pandemic-related stress among U.S. women pregnant at the start of the COVID-19 pandemic

Preis

Mahaffey

Heiselman

et al. 2020

Social Science & Medicine

234

237

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Rationale Women pregnant during the COVID-19 pandemic are experiencing moderate to high levels of emotional distress, which has previously been shown to be attributable to two types of pandemic-related pregnancy stress: stress associated with feeling unprepared for birth due to the pandemic (Preparedness Stress) and stress related to fears of perinatal COVID-19 infection (Perinatal Infection Stress). Objective . Given the well-documented harms associated with elevated prenatal stress and the critical importance of developing appropriately targeted interventions, we investigated factors predictive of pandemic-related pregnancy stress. Method . Between April 25 and May 15, 2020, 4,451 pregnant women in the U.S. were recruited via social media to complete an online questionnaire that included sociodemographic, medical, and COVID-19 situational factors, as well as the Pandemic-Related Pregnancy Stress Scale (PREPS). Binary logistic regression was used to calculate odds ratios for high stress. Results . Nearly 30% of participants reported high Preparedness Stress; a similar proportion reported high Perinatal Infection Stress. Abuse history, chronic illness, income loss due to the pandemic, perceived risk of having had COVID-19, alterations to prenatal appointments, high-risk pregnancy, and being a woman of color were associated with greater levels of one or both types of stress. Access to outdoor space, older age, and engagement in healthy behaviors were protective against stress. Conclusions . Practices that may alleviate pandemic-related stress such as minimizing disruptions to prenatal care, ensuring access to outdoor space, and motivating engagement in health behaviors are of vital importance. Particular attention is needed for more vulnerable populations including women of color, women with a history of abuse, and those with high-risk pregnancy. Research focused on the short and longer-term impact of pandemic-related pregnancy stress on maternal mental and physical health, perinatal outcomes, and child development is critical to identify these effects and marshal appropriate resources to reduce them.

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“…Authors of one review analyzed several studies related to lockdown periods following upper respiratory tract viruses [ 52 ] and found several factors associated with health risks such as smoking, diet, and psychological stress. In contrast with these, PA, social integration and support, good sleep quality, and mild alcohol intake seemed to reduce health risks.…”

Section: Discussionmentioning

confidence: 99%

Psychological Health and Physical Activity Levels during the COVID-19 Pandemic: A Systematic Review

Violant‐Holz

Gallego-Jiménez

González-González

et al. 2020

IJERPH

277

198

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The coronavirus disease (COVID-19) pandemic has been devastating in all senses, particularly psychologically. Physical activity (PA) is known to aid psychological well-being, and it is worth investigating whether PA has been a coping strategy during this pandemic. The objective of this literature review is to analyze the extent to which engaging in PA during the COVID-19 pandemic impacts psychological health in the adult population. The literature was searched in all databases from the EBSCOhost Research Database—MEDLINE, APA PsycArticles, between others—published between 1 January 2019 and 15 July 2020. From 180 articles found, 15 were eligible. The reviewed articles showed an association between mental health distress—e.g., stress, anxiety, depressive symptoms, social isolation, psychological distress—and PA. This research concludes that the COVID-19 pandemic and the lockdown measures caused psychological distress. Those studies that analyzed PA showed that, during quarantine, adults increased their sedentary time and reduced their PA levels, showing controversial psychological outcomes. This review discusses whether PA is an effective strategy to face the COVID-19 pandemic psychological effects contributing to a further putative increase in the prevalence of psychiatric disorders.

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Psychosocial Vulnerabilities to Upper Respiratory Infectious Illness: Implications for Susceptibility to Coronavirus Disease 2019 (COVID-19)

Cited by 100 publications

References 71 publications

Pre-pandemic psychiatric disorders and risk of COVID-19: a UK Biobank cohort analysis

Pre-pandemic psychiatric disorders and risk of COVID-19: a UK Biobank cohort analysis

Vulnerability and resilience to pandemic-related stress among U.S. women pregnant at the start of the COVID-19 pandemic

Psychological Health and Physical Activity Levels during the COVID-19 Pandemic: A Systematic Review

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