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

Brain Behav Immun. 2020 Oct;89:569-578. doi: 10.1016/j.bbi.2020.06.021. Epub 2020 Jun 17.

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 40-69 years at study induction between 2006 and 2010 when information on psychosocial factors and covariates were captured. Hospitalisations 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 risk of the infection remained (1.98; 1.38, 2.85).

Conclusions: A range of psychosocial factors revealed associations with hospitalisation for COVID-19 of which the relation with cognitive function, a marker of health literacy, was most robust.

Keywords: COVID-19; Cohort study; Hospitalisation; Risk factors; UK Biobank.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Betacoronavirus
  • COVID-19
  • Cognition*
  • Cohort Studies
  • Coronavirus Infections / epidemiology*
  • Educational Status
  • Female
  • Hospitalization / statistics & numerical data*
  • Humans
  • Income / statistics & numerical data
  • Male
  • Mental Health
  • Middle Aged
  • Neuroticism
  • Occupations / statistics & numerical data
  • Pandemics
  • Pneumonia, Viral / epidemiology*
  • Prospective Studies
  • Psychological Distress
  • Psychology
  • Reaction Time
  • Residence Characteristics
  • Risk Factors
  • SARS-CoV-2
  • United Kingdom / epidemiology