Psychosocial factors and hospitalisations for COVID-19: Prospective cohort study based on a community sample

G David. Batty, Ian Deary, Michelle Luciano, Drew Altschul, Mika Kivimaki, Catharine Gale

Research output: Contribution to journalArticlepeer-review

Abstract

Background
While certain infectious diseases have been linked to socioeconomic disadvantage, mental health problems, and lower cognitive function, relationships with COVID-19 are either uncertain or untested. Our objective was to examine the association of a range of psychosocial factors with hospitalisation for COVID-19.

Methods
UK Biobank, a prospective cohort study, comprises around half a million people who were aged 40 to 69 years at study induction between 2006 and 2010 when information on psychosocial factors and covariates were captured. Hospitalisation for COVID-19 were ascertained between 16th March and 26th April 2020.

Results
There were 908 hospitalisations for COVID-19 in an analytical sample of 431,051 England-based study members. In age- and sex-adjusted analyses, an elevated risk of COVID-19 was related to disadvantaged levels of education (odds ratio; 95% confidence interval: 2.05; 1.70, 2.47), income (2.00; 1.63, 2,47), area deprivation (2.20; 1.86, 2.59), occupation (1.39; 1.14, 1.69), psychological distress (1.58; 1.32, 1.89), mental health (1.50; 1.25, 1.79), neuroticism (1.19; 1.00, 1.42), and performance on two tests of cognitive function – verbal and numerical reasoning (2.66; 2.06, 3.34) and reaction speed (1.27; 1.08, 1.51). These associations were graded (p-value for trend ≤0.038) such that effects were apparent across the full psychosocial continua. After mutual adjustment for these characteristics plus ethnicity, comorbidity, and lifestyle factors, only the relationship between lower cognitive function as measured using the reasoning test and a doubling in the risk of the infection remained (1.98; 1.38, 2.85).

Conclusions
A range of psychosocial factors revealed associations with hospitalisations for COVID-19 of which the relation with cognitive function, a marker of health literacy, was most robust.
Original languageEnglish
JournalBrain, Behavior, and Immunity
Early online date17 Jun 2020
DOIs
Publication statusE-pub ahead of print - 17 Jun 2020

Keywords

  • risk factors
  • COVID-19
  • hospitalisation
  • cohort study
  • UK Biobank

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