recently found that a diagnosis of poor mental health was associated with an increased risk of COVID-19. We have previously explored the role of explanatory characteristics such as ethnicity,
and vascular risk indices
in the relationship between mental health
and COVID-19 using data from UK Biobank, a field-based prospective cohort study of around 0·5 million people. In those analyses, our outcome of interest was hospitalisation with COVID-19. We now use 2020 data on death from the disease.
In UK Biobank (2006–10), self-reported mental health was captured using two indices at baseline. Study members were asked whether they had ever been under the care of a psychiatrist for any mental health problem. Symptoms of psychological distress (a combination of anxiety and depression) were measured using the validated four item version of the Patient Health Questionnaire with a total score from 0 to 12 (higher scores denote greater distress). Socioeconomic status was quantified using self-reported educational qualifications (degree, other qualifications, no qualifications) and the Townsend index of neighbourhood deprivation (higher scores denote greater disadvantage). Ethnicity was categorised as White, Asian, Black, Chinese, Mixed, or other. Baseline vascular or heart problems, diabetes, chronic lung disease, and asthma, were based on a self-reported physician diagnosis. The presence of hypertension was defined as a blood pressure of 140/90 mmHg or higher or self-reported use of antihypertensive medication, or both. C-reactive protein, glycated haemoglobin, and high-density lipoprotein cholesterol concentrations were based on assays of non-fasting venous blood. Height, weight, and forced expiratory volume in 1 s were measured using standard protocols. Cigarette smoking, physical activity, and alcohol consumption were assessed using standard questions. Study members were linked to national mortality records and death from COVID-19, as denoted by the emergency ICD-10 code U07·1 (COVID-19, virus identified).
TablePre-pandemic self-reported mental health and COVID-19 mortality
Data analysed from UK Biobank, shown as hazard ratios (95% CI), unless stated otherwise.
We declare no competing interests.
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© 2021 Published by Elsevier Ltd.