Stress, anxiety, and depression are not only consequences of living with the pandemic, but may also be factors that increase our risk of contracting COVID-19

stress with covid

Researchers from the University of Nottingham School of Medicine, King’s College London, and the University of Auckland in New Zealand have concluded that COVID-19 infection and symptoms may be more common among those experiencing elevated psychological distress.

In their study, published in the Annals of Behavioural Medicine, the researchers point out that stress, social support, and other psychological factors are known to be ‘associated with greater susceptibility to viral illnesses and more severe symptoms’.

Professor Trudie Chalder, Professor of Cognitive Behavioural Psychotherapy at King’s College London, said: ‘Previous work has shown a clear relationship between distress and the development of viral infections, indicating a vulnerability.’

The researchers wanted to investigate whether the same applied to COVID-19 infection.

Effect of psychological distress on COVID-19 infection demonstrated for the first time

To examine the relationship between psychological factors, the risk of self-reported COVID-19 infection, and the number and severity of COVID-19-related symptoms, the researchers recruited participants through social media platforms, such as Facebook and Twitter, and via a mainstream media campaign. They performed a large, prospective cohort study involving 1087 participants, who completed surveys on psychological wellbeing during April 2020, and on self-reported COVID-19 infection and symptoms throughout the pandemic to December 2020. Of the participants, 85% were female, the mean age was 50 years, and 42% were key workers.

The authors said that, as far as they were aware, ‘this is the first study to demonstrate a small but significant effect of psychological distress on both the likelihood of reporting COVID-19 infection and the symptom experience.’

Debate on the mental health aspects of the COVID-19 pandemic ‘turned on its head’

The authors discuss how who gets COVID-19 and who doesn’t—and for those who do contract the infection, how severe their symptoms are—may be related to psychological distress, which they say has been ‘operationalised as a constellation of increased stress, anxiety, and depression and low levels of positive mood.’ In turn, they question whether a person’s response to COVID-19 vaccination—that is, how effective the vaccine is—may also be influenced by their psychological wellbeing.

Professor Kavita Vedhara from the School of Medicine at the University of Nottingham, who led the study, said: ‘The significance of the work is in that it turns the debate regarding the mental health aspects of the pandemic on its head.’

He added that their findings show that ‘increased stress, anxiety, and depression are not only consequences of living with the pandemic, but may also be factors that increase our risk of getting SARS-CoV-2 too.’

In the study, the authors also raise the question of whether a high level of worry about COVID-19 is associated with a greater risk of COVID-19 infection. However, they state that further research is needed to disentangle these findings.

Professor Chalder said: ‘Our study found that distress was associated with self-reported COVID-19 infection, and the next step is to investigate whether this association is found in those with confirmed infection.’

Professor Vedhara added: ‘Further work is now needed to determine whether and how public health policy should change to accommodate the fact that the most distressed people in our communities appear to be at greatest risk of COVID-19 infection.’

This article originally appeared on Medscape, part of the Medscape Professional Network.

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