Psychosocial factors and hospitalisations for COVID-19: Prospective cohort study of the general population

OBJECTIVE: To examine the association of a range of psychosocial factors with hospitalisation for COVID-19. DESIGN: Prospective cohort study. SETTING: England. PARTICIPANTS: UK Biobank 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. MAIN OUTCOME MEASURE: Hospitalisation for COVID-19 in England between 16(th) March and 26(th) April 2020 as provided by Public Health England. RESULTS: There were 908 hospitalisations for COVID-19 in an analytical sample of 431,051 people. 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). CONCLUSION: A range of psychosocial factors revealed associations with hospitalisations for COVID-19 of which the relation with cognitive function was most robust to statistical adjustment.