Table 3.
Association of forms of distress prior to infection and risk of COVID-19 hospitalization among persons testing positive for SARS-CoV-2, April 2020 - April 2021, N=3,663
| Hospitalized/Positive tests (N) | Model 1: age, sex, and racial identity, healthcare worker status, and partner’s education | Model 2: Model 1 further adjusted for smoking and BMI | Model 3: Model 2 further adjusted for hypertension, diabetes, asthma, high cholesterol, and cancer | |
|---|---|---|---|---|
|
|
||||
| Risk ratio (95% confidence interval) | ||||
|
|
||||
| Prior to the pandemic | ||||
| Chronic depression in the decade prior to the pandemic | 52/979 | 1.72 (1.20-2.46) | 1.47 (1.02-2.11) | 1.34 (0.93-1.93) |
| At COVID-19 study baseline | ||||
| Probable depression (PHQ-2) | ||||
| No (0 points) | 58/1790 | 1.0 [Reference] | 1.0 [Reference] | 1.0 [Reference] |
| Subclinical symptoms (1-2 points) | 54/1389 | 1.37 (0.95-1.99) | 1.30 (0.90-1.89) | 1.26 (0.87-1.83) |
| Yes (3-6 points) | 20/477 | 1.81 (1.08-3.03) | 1.59 (0.95-2.67) | 1.46 (0.87-2.46) |
| Depressive symptoms, continuous, per approximate IQR | 1.45 (1.17-1.81) | 1.37 (1.10-1.71) | 1.32 (1.06-1.65) | |
| Probable anxiety (GAD-2) | ||||
| No (0 points) | 51/1349 | 1.0 [Reference] | 1.0 [Reference] | 1.0 [Reference] |
| Subclinical symptoms (1-2) | 55/1541 | 1.21 (0.83-1.79) | 1.20 (0.81-1.76) | 1.18 (0.80-1.74) |
| Yes (3-6 points) | 26/767 | 1.34 (0.82-2.16) | 1.23 (0.76-2.00) | 1.16 (0.71-1.88) |
| Anxiety symptoms, continuous, per approximate IQR | 1.18 (0.94-1.48) | 1.14 (0.91-1.43) | 1.11 (0.88-1.39) | |
| Worry about COVID | ||||
| Not at all/not very worried | 37/1105 | 1.0 [Reference] | 1.0 [Reference] | 1.0 [Reference] |
| Somewhat worried | 61/1957 | 1.05 (0.69-1.58) | 0.98 (0.65-1.47) | 0.97 (0.64-1.46) |
| Very worried | 34/597 | 1.79 (1.12-2.86) | 1.55 (0.96-2.48) | 1.51 (0.94-2.42) |
| P trend* | 0.02 | 0.10 | 0.12 | |
| Among participants who indicated they were not currently frontline healthcare workers (n=1,754) | ||||
| Perceived stress, per approximate IQR | 88/1754 | 1.09 (0.79-1.49) | 1.04 (0.76-1.41) | 1.00 (0.73-1.36) |
| Loneliness | ||||
| Hardly ever (3 points) | 19/489 | 1.0 [Reference] | 1.0 [Reference] | 1.0 [Reference] |
| Less than some of the time (4-5 points) | 36/748 | 1.33 (0.76-2.32) | 1.26 (0.72-2.20) | 1.22 (0.70-2.14) |
| Some of the time or often (6-9 points) | 33/501 | 1.81 (1.02-3.20) | 1.67 (0.95-2.97) | 1.58 (0.89-2.81) |
| Loneliness score, continuous, per approximate IQR | 1.29 (1.01-1.65) | 1.23 (0.96-1.56) | 1.20 (0.94-1.53) | |
Note. PHQ-2 = 2-item Patient Health Questionnaire-2; GAD-2 = 2-item Generalized Anxiety Disorder; perceived stress and loneliness were queried in non-active health care workers only. IQR, interquartile range
*
P trend analysis used indicator levels as a continuous variable.