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History of childhood maltreatment associated with hospitalization or death due to COVID-19: a cohort study

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机构： [1]Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland. [2]Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden. [3]PsychGen Centre for Genetic Epidemiology and Mental Health, Norwegian Institute of Public Health, Oslo, Norway. [4]Department of Psychology, University of Oslo, Oslo, Norway. [5]School of Population Health, Faculty of Medicine and Health, UNSW Sydney, Sydney, Australia. [6]Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, Tongji University School of Medicine, Shanghai, China. [7]Institute for Advanced Study, Tongji University, Shanghai, China. [8]Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK. [9]Generation Scotland, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, UK. [10]Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. [11]Department of Clinical Immunology, Zealand University Hospital, Roskilde, Denmark. [12]Estonian Genome Centre, Institute of Genomics, University of Tartu, Tartu, Estonia. [13]Institute of Clinical Medicine, NORMENT Centre, University of Oslo, Oslo, Norway. [14]Division of Mental Health and Addiction, NORMENT Centre, Oslo University Hospital, Oslo, Norway. [15]West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China. [16]Med-X Center for Informatics, Sichuan University, Chengdu, Sichuan, China. [17]Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA.

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关键词： COVID-19 Hospitalization Mortality Childhood maltreatment Psychiatric disorders

摘要：

Childhood maltreatment (CM) has been indicated in adverse health outcomes across the lifespan, including severe infection-related outcomes. Yet, data are scarce on the potential role of CM in severe COVID-19-related outcomes as well as on mechanisms underlying this association.We included 151,427 individuals in the UK Biobank who responded to questions on the history of CM in 2016 and 2017 and were alive on January 31, 2020. Binomial logistic regression models were performed to estimate the association between a history of CM and severe COVID-19 outcomes (i.e. hospitalization or death due to COVID-19), as well as COVID-19 diagnosis and vaccination as secondary outcomes. We then explored the potential mediating roles of socio-economic status, lifestyle and pre-pandemic comorbidities, and the effect modification by polygenic risk score for severe COVID-19 outcomes.The mean age of the study population at the start of the pandemic was 67.7 (SD = 7.72) years, and 56.5% were female. We found the number of CM types was associated with the risk of severe COVID-19 outcomes in a graded manner (pfor trend < 0.01). Compared to individuals with no history of CM, individuals exposed to any CM were more likely to be hospitalized or die due to COVID-19 (odds ratio [OR] = 1.54 [95%CI 1.31-1.81]), particularly after physical neglect (2.04 [1.57-2.62]). Largely comparable risk patterns were observed across groups of high vs. low genetic risks for severe COVID-19 outcomes (pfor difference > 0.05). Mediation analysis revealed that 50.9% of the association between CM and severe COVID-19 outcomes was explained by suboptimal socio-economic status, lifestyle, and pre-pandemic diagnosis of psychiatric disorders or other chronic medical conditions. In contrast, any CM exposure was only weakly associated with COVID-19 diagnosis (1.06 [1.01-1.12]) while significantly associated with not being vaccinated for COVID-19 (1.21 [1.13-1.29]).Our results add to the growing knowledge base indicating the role of childhood maltreatment in negative health outcomes across the lifespan, including severe COVID-19-related outcomes. The identified factors underlying this association represent potential intervention targets for mitigating the harmful effects of childhood maltreatment in COVID-19 and similar future pandemics.© 2024. The Author(s).

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大类 | 1 区

医学

小类 | 1 区医学：内科

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大类 | 1 区

医学

小类 | 1 区医学：内科

第一作者：

第一作者机构： [1]Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland. [2]Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.

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通讯机构： [1]Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland. [2]Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden. [17]Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA.

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History of childhood maltreatment associated with hospitalization or death due to COVID-19: a cohort study

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