How the gut may help to drive COVID-19

September 3, 2022

Science Daily/Flinders University

New findings from Flinders University have demonstrated a molecular link between COVID-19 and serotonin cells in the gut.

The research could help provide further clues to what could be driving COVID-19 infection and disease severity and supports previous evidence that antidepressants, known as selective serotonin reuptake inhibitors (SSRIs), could reduce the severity of COVID symptoms.

COVID-19 displays an array of symptoms, which can regularly include gastrointestinal issues such as diarrhoea. Recent research has indicated that these gut symptoms in COVID-19 patients worsen with the severity of the disease, and this is linked to heightened gut-derived serotonin, released to cause gut dysfunction, increasing the body's immune response and potentially worsening patient outcomes.

Published in the world's leading gastrointestinal research journal Gut, this new collaborative study involved three Flinders research teams, including teams led by ARC DECRA Fellow Dr Alyce Martin and FAME Director of Bioinformatics and Human-Microbe Interactions, Professor Robert Edwards.

"Our study endeavoured to understand whether the gut could be a site of disease transmission and what genes might be associated with the virus entering the cells lining the gut wall," says study senior author Professor Damien Keating, Deputy Director of the Flinders Health and Medical Research Institute and Head of the Gut Sensory Systems research group.

The researchers looked at gene expression amongst the different cell types that line the gut wall, analysing whole genome sequences from thousands of individual cells from within the intestine.

They found specialised cells within the gut that synthesised and released serotonin had a highly enriched expression of a particular SARS-CoV-2 receptor and were the only type of cell that expressed all the genes associated with COVID-19.

"Many genes linked to COVID-19 were found expressed in the different cell types lining the gut wall but only serotonin cells expressed all three receptors for the virus," says Professor Keating.

"Expression of all three SARS-CoV-2 receptors triples the rate of cell infectivity, compared to expression of only two receptors."

With the exact sites of infection and the primary drivers of COVID-19 disease severity not yet fully understood, the authors say this study provides important information on the gut's role in the virus.

"Our study adds further evidence that COVID-19 is far more likely to infect cells in the gut and increase serotonin levels through direct effects on specific gut cells, potentially worsening disease outcomes," says Professor Keating.

"It also provides further support to emerging clinical evidence that antidepressant drugs, which block serotonin transport around the body, may serve as a beneficial treatment.

"As COVID-19 continues to circulate, further research will be required to advance our understanding of the gut's role in this virus and continue to find treatment options to work alongside vaccinations."

https://www.sciencedaily.com/releases/2022/09/220901135944.htm

Low testosterone may increase risk of COVID-19 hospitalization for men

Boosting testosterone in men with low levels may reduce serious illness

September 2, 2022

Science Daily/Washington University School of Medicine

Among men diagnosed with COVID-19, those with low testosterone levels are more likely to become seriously ill and end up in the hospital than men with normal levels of the hormone, according to a study by researchers at Washington University School of Medicine in St. Louis and Saint Louis University School of Medicine.

The team analyzed the cases of 723 men who tested positive for COVID-19, mostly in 2020 before vaccines were available. The data indicate that low testosterone is an independent risk factor for COVID-19 hospitalization, similar to diabetes, heart disease and chronic lung disease.

They found that men with low testosterone who developed COVID-19 were 2.4 times more likely to require hospitalization than men with hormone levels in the normal range. Further, men who were once diagnosed with low testosterone but successfully treated with hormone replacement therapy were no more likely to be hospitalized for COVID-19 than men whose testosterone levels had always tested in the normal range.

The findings, published Sept. 2 in JAMA Network Open, suggest that treating men with low testosterone may help protect them against severe disease and reduce the burden on hospitals during COVID-19 waves.

"It is very likely that COVID-19 is here to stay," said co-senior author Abhinav Diwan, MD, a professor of medicine at Washington University. Diwan, who treats patients at Barnes-Jewish Hospital, is also a professor of cell biology & physiology, and of obstetrics & gynecology. "Hospitalizations with COVID-19 are still a problem and will continue to be a problem because the virus keeps evolving new variants that escape immunization-based immunity. Low testosterone is very common; up to a third of men over 30 have it. Our study draws attention to this important risk factor and the need to address it as a strategy to lower hospitalizations."

Diwan and co-senior author Sandeep Dhindsa, MD, an endocrinologist at Saint Louis University, previously had shown that men hospitalized with COVID-19 have abnormally low testosterone levels. However, severe illness or traumatic injury can cause hormone levels to drop temporarily. Data from men who are already hospitalized with COVID-19 doesn't really answer the question of whether low testosterone is a risk factor for severe COVID-19 or a result of it. For that, the researchers needed to know whether men with chronically low testosterone levels get sicker than men with normal levels.

Diwan, Dhindsa and colleagues -- including co-author Cosette Champion, MD, an internal medicine resident at Barnes-Jewish -- conducted a chart review of patients at SSM Health and BJC HealthCare, two major hospital systems in the St. Louis area. They identified 723 men whose testosterone levels had been measured between Jan. 1, 2017, and Dec. 31, 2021, and who had documented cases of COVID-19 in 2020 or 2021. In some cases, testosterone levels were measured after the patient recovered from COVID-19. Since low testosterone is a chronic condition, men who tested low a few months after recovering from COVID-19 probably had low levels before as well, Dhindsa said.

The researchers identified 427 men with normal testosterone levels, 116 with low levels, and 180 who previously had low levels but were being successfully treated, meaning that they were on hormone replacement therapy and their testosterone levels were in the normal range at the time they developed COVID-19.

"Low testosterone turned out to be a risk factor for hospitalization from COVID, and treatment of low testosterone helped to negate that risk," Dhindsa said. "The risk really takes off below a level of 200 nanograms per deciliter, with the normal range being 300 to 1,000 nanograms per deciliter. This is independent of all other risk factors that we looked at: age, obesity or other health conditions. But those people who were on therapy, their risk was normal."

Men with low testosterone levels can experience sexual dysfunction, depressed mood, irritability, difficulty with concentration and memory, fatigue, loss of muscular strength and a reduced sense of well-being overall. When a man's quality of life is clearly diminished, he is typically treated with testosterone replacement therapy. When the symptoms are mild, though, doctors and patients may hesitate to treat.

The two main concerns related to testosterone therapy are an increased risk of prostate cancer and heart disease. Prostate cancer is common in older men, and it is often driven by testosterone. Boosting testosterone could possibly speed the growth of such cancers, worsening the disease. For heart disease, the evidence for risk is more ambiguous. A large clinical trial on the relationship between heart health and testosterone supplementation is expected to be completed soon.

"In the meantime, our study would suggest that it would be prudent to look at testosterone levels, especially in people who have symptoms of low testosterone, and then individualize care," said Diwan, whose specialty is cardiology. "If they are at really high risk of cardiovascular events, then the doctor could engage the patient in a discussion of the pros and cons of hormone replacement therapy, and perhaps lowering the risk of COVID hospitalization could be on the list of potential benefits."

This study is observational, so it only suggests -- not proves -- that boosting testosterone levels may help men avoid severe COVID-19, Diwan cautioned. A clinical trial would be needed to demonstrate conclusively whether such a strategy works.

https://www.sciencedaily.com/releases/2022/09/220902111333.htm

COVID rekindled an appreciation of nature for many

An opportunity to rediscover why the great outdoors are so great in the first place

September 2, 2022

Science Daily/University of Connecticut

The pandemic has impacted our lives in a multitude of ways, many of which will no doubt be felt for years to come. While many of those effects are clearly negative, UConn researchers have identified at least one positive impact -- our perception of natural spaces changed. The findings are published in Nature Scientific Reports.

As people flocked to outdoor spaces for recreation in the spring of 2020, Sohyun Park, assistant professor in UConn's College of Agriculture, Health and Natural Resources Department of Plant Science and Landscape Architecture, noticed some interesting trends: more people were on the trails, and many of those people had traveled from far away to enjoy nature.

Park was also part of the team for the Connecticut Trail Census and co-wrote a paper about the trends.

Sohyun Park of the Department of Plant Science and Landscape Architecture in her office in the W.B. Young Building. Mar. 8, 2022. (Jason Sheldon/UConn Photo)

"What's interesting was rural trail use increased compared to urban trails," Park says. "I wanted to try to find out how people were changing their mindset or their attitudes or perceptions."

To do this, Park and co-authors Seungman Kim and Jaehoon Lee of Texas Tech University, and Biyoung Heo of James Corner Field Operations, looked to social media data and machine learning techniques to help make sense of the vast quantities of information on Twitter and try to find a pattern among those data, says Park. They utilized Twitter's Application Programming Interface (API), which allows researchers to obtain aggregated data from Twitter posts.

"We wanted to know from the people who have been in greenspaces, what were they doing and what they were writing about on Twitter. We utilized very innovative and advanced levels of machine learning methods," says Park. "The machine categorized the keywords and classified them into several human-recognizable groups. One group was nature related. The second group is all traditional park-related activities and the third one is obviously the COVID-related one, so mask wearing and social distancing, and things like that."

A newfound appreciation for nature

Though what people were doing in the parks did not change significantly, the researchers noticed some significant changes in keyword usage between pre-pandemic and pandemic Twitter, with people frequently referencing nature, and their experiences within it.

"Users began to put the word 'nature' and nature-related activities or nature-related pictures on their Twitter," Park says. "It was very interesting because, in the past, there were not many keywords like that, but people used keywords like 'playing', 'walking the dog', 'baseball', and other traditional, active park activities that they were enjoying while they were there in the parks. If you look at post- 2020 Twitter, you can also see keywords thanking God or showing appreciation for nature, describing the birds singing or water sounds."

What the researchers found was people seemed to have realized a newfound appreciation for nature and greenspaces, especially true for those in urban settings. As a landscape architect, Park was interested to see if there was something more to the findings and perhaps if there might be some design implications for the results.

Common features in modern parks include benches, walking paths, and sports fields, for instance. However, Park says the results of the paper seem to suggest that natural greenspaces appeal to people differently.

"We might want to go back to the origin of public parks like those Olmsted designed," Park says. "In his time in 19th century, there was a lot of hustle and bustle in the city, and they wanted to have space for people to find respite and peace. We might want to go back to that era living with a 21st century health crisis and try to rethink about the design principles."

Park says to imagine Manhattan's Central Park, which hosts ponds, wooded areas, and meadows. Most of those natural features were introduced artificially and were not there in the first place. Compare this with contemporary parks:

"Modern parks may be well managed, maintained, and manicured, everything is clean and tidy," Park says. "There are some seating areas, paved surfaces, and structures where you can play something with your friends and family members, but not really in a naturalistic style. People can feel that in public spaces."

The outdoors as essential resource for overall well-being

Greenspaces impact mental, physical, and spiritual health, and Park reasons that these natural elements might be essential in public spaces, particularly for those who have less access to the public parks, or marginalized communities that don't have any green areas at their residences.

"I'm arguing that parks are not only recreational spaces; greenspaces and parks serve as essential amenities for all including those with low incomes or disabilities, and the elderly," Park says. "Parks need inclusive planning approaches that might be added to the current principles for park development."

Park explains that many people are involved in the planning, design, and management of parks and greenspaces. The tricky part is that the more naturalistic, garden concept for public parks may require more planning and maintenance, and therefore these design features rely more heavily on resources and budgets.

"In the long term, I think that will be the direction that we need to go and now officials and park managers need to work together with those who are living nearby so that we can have some kind of co-managing type of approaches to the future," Park says.

This study highlights the importance of those design features and their roles in our emotional and spiritual well-being, and Park says it is important for the public to advocate for our greenspaces. Research like this can inform decision-making.

"It is important for the public and decision-makers to understand that ultimately, we need to have a budget to have more natural features and nature-oriented programs in the park. We all need to be more active in terms of the things that towns are doing. That can start with joining your town's Conservation Commission or attending monthly meetings. Participate and make your voice heard. That makes a huge change and can impact big decisions. Sometimes these decision makers are really grounded by how the stakeholders are feeling so giving some input and feedback on the public decision-making should be the first step. It is empowering and more people need to be involved in public planning."

https://www.sciencedaily.com/releases/2022/09/220902103241.htm

COVID-19 infection in crucial brain regions may lead to accelerated brain aging

Study finds this may put vulnerable individuals at risk for irreversible neurological conditions

July 28, 2022

Science Daily/Houston Methodist

A new study by Houston Methodist researchers reviews the emerging insights and evidence that suggest COVID-19 infections may have both short- and long-term neurological effects. Major findings include that COVID-19 infections may predispose individuals to developing irreversible neurological conditions, may increase the likelihood of strokes and may increase the chance of developing persistent brain lesions that can lead to brain bleeding.

Led by corresponding authors Joy Mitra, Ph.D., Instructor, and Muralidhar L. Hegde, Ph.D., Professor of Neurosurgery, with the Division of DNA Repair within the Center for Neuroregeneration at the Houston Methodist Research Institute, the research team described their findings in an article titled "SARS-CoV-2 and the Central Nervous System: Emerging Insights into Hemorrhage-Associated Neurological Consequences and Therapeutic Considerations" online in press July 16 in the journal Ageing Research Reviews.

Still a major burden on our daily lives, a great deal of research has shown that the impacts of the disease go far beyond the actual time of infection. Since the onset of the pandemic, COVID-19 has surpassed a death toll of over 5.49 million worldwide and over 307 million confirmed positive cases, with the U.S. accounting for almost 90 million of those cases, according to the Our World in Data website.

COVID-19 is known to invade and infect the brain, among other major organs. While a lot of research has been done to help us understand the evolution, infection and pathology of the disease, there is still a great deal that remains unclear about the long-term effects, especially on the brain.

The coronavirus infection can cause long-term and irreversible neurodegenerative diseases, particularly in the elderly and other vulnerable populations. Several brain imaging studies on COVID-19 victims and survivors have confirmed the formation of microbleed lesions in deeper brain regions related to our cognitive and memory functions. In this review study, researchers have critically evaluated the possible chronic neuropathological outcomes in aging and comorbid populations if timely therapeutic intervention is not implemented.

Microbleeds are emerging neuropathological signatures frequently identified in people suffering from chronic stress, depressive disorders, diabetes and age-associated comorbidities. Based on their earlier findings, the investigators discuss how COVID-19-induced microhemorrhagic lesions may exacerbate DNA damage in affected brain cells, resulting in neuronal senescence and activation of cell death mechanisms, which ultimately impact brain microstructure-vasculature. These pathological phenomena resemble hallmarks of neurodegenerative conditions like Alzheimer's and Parkinson's diseases and are likely to aggravate advanced-stage dementia, as well as cognitive and motor deficits.

The effects of COVID-19 infection on various aspects of the central nervous system are currently being studied. For instance, 20-30% of COVID-19 patients report a lingering psychological condition known as "brain fog" where individuals suffer from symptoms such as memory loss, difficulty in concentrating, forgetting daily activities, difficulty in selecting the right words, taking longer than usual time to complete a regular task, disoriented thought processes and emotional numbness.

More severe long-term effects analyzed in the Houston Methodist review article include predispositions for Alzheimer's, Parkinson's and related neurodegenerative diseases, as well as cardiovascular disorders due to internal bleeding and blood clotting-induced lesions in the part of the brain that regulates our respiratory system, following the COVID-19 symptoms. Additionally, cellular aging is thought to be accelerated in COVID-19 patients. A plethora of cellular stresses inhibit the virus-infected cells from undergoing their normal biological functions and let them enter into "hibernation mode" or even die completely.

The study also suggests various strategies to improve some of these long-term neuropsychiatric and neurodegenerative outcomes, as well as outlines the importance of the therapeutic regimen of the "nanozyme" in combination with various FDA-approved drugs that may prove successful to fight against this catastrophic disease.

However, given the ever-evolving nature of this field, associations like the ones described in this review show the fight against COVID-19 is far from over, say the investigators, and reinforce the message that getting vaccinated and maintaining proper hygiene are key in trying to prevent such long-term and detrimental consequences.

https://www.sciencedaily.com/releases/2022/07/220728143030.htm

Social isolation is directly associated with later dementia

June 8, 2022

Science Daily/University of Warwick

Interdisciplinary study shows changes to brain structures associated with memory and cognitive function are directly linked to social isolation. The data shows that socially isolated people are 26% more likely to develop later dementia. The study has implications for health and social care policy, in the wake of the COVID-19 pandemic.

Social isolation is directly linked with changes in the brain structures associated with memory, making it a clear risk factor for dementia, scientists have found.

Setting out to investigate how social isolation and loneliness were related to later dementia, researchers at the University of Warwick, University of Cambridge and Fudan University used neuroimaging data from more than 30,000 participants in the UK Biobank data set. Socially isolated individuals were found to have lower gray matter volumes of brain regions involved in memory and learning.

The results of the study are published online today (June 8, 2022) in Neurology, the medical journal of the American Academy of Neurology, in a paper entitled "Associations of social isolation and loneliness with later dementia" by Shen, Rolls, Cheng, Kang, Dong, Xie, Zhao, Sahakian and Feng.

Based on data from the UK Biobank, an extremely large longitudinal cohort, the researchers used modelling techniques to investigate the relative associations of social isolation and loneliness with incident all-cause dementia. After adjusting for various risk factors (including socio-economic factors, chronic illness, lifestyle, depression and APOE genotype), socially isolated individuals were shown to have a 26% increased likelihood of developing dementia.

Loneliness was also associated with later dementia, but that association was not significant after adjusting for depression, which explained 75% of the relationship between loneliness and dementia. Therefore, relative to the subjective feeling of loneliness, objective social isolation is an independent risk factor for later dementia. Further subgroup analysis showed that the effect was prominent in those over 60 years old.

Professor Edmund Rolls, neuroscientist from the University of Warwick Department of Computer Science, said: "There is a difference between social isolation, which is an objective state of low social connections, and loneliness, which is subjectively perceived social isolation.

"Both have risks to health but, using the extensive multi-modal data set from the UK Biobank, and working in a multidisciplinary way linking computational sciences and neuroscience, we have been able to show that it is social isolation, rather than the feeling of loneliness, which is an independent risk factor for later dementia. This means it can be used as a predictor or biomarker for dementia in the UK.

"With the growing prevalence of social isolation and loneliness over the past decades, this has been a serious yet underappreciated public health problem. Now, in the shadow of the COVID-19 pandemic there are implications for social relationship interventions and care -- particularly in the older population."

Professor Jianfeng Feng, from the University of Warwick Department of Computer Science, said: "We highlight the importance of an environmental method of reducing risk of dementia in older adults through ensuring that they are not socially isolated. During any future pandemic lockdowns, it is important that individuals, especially older adults, do not experience social isolation."

Professor Barbara J Sahakian, of the University of Cambridge Department of Psychiatry, said: "Now that we know the risk to brain health and dementia of social isolation, it is important that the government and communities take action to ensure that older individuals have communication and interactions with others on a regular basis."

https://www.sciencedaily.com/releases/2022/06/220608161434.htm

COVID-19 vaccination in pregnancy helps protect infants from needing hospital care for COVID-19

CDC study results reinforce importance of COVID-19 vaccination during pregnancy

June 24, 2022

Science Daily/Ann & Robert H. Lurie Children's Hospital of Chicago

In a new study sponsored by the Centers for Disease Control and Prevention and published in the New England Journal of Medicine, researchers provide additional evidence that COVID-19 vaccination during pregnancy helps protect babies younger than 6 months from being hospitalized due to COVID-19. The risk of COVID-19 hospitalization among babies was reduced by about 80 percent during the Delta wave (July 1-December 18, 2021) and 40 percent during the Omicron wave (December 19-March 8, 2022).

"Our results reinforce the importance of COVID-19 vaccination during pregnancy to protect both the women and their babies from COVID-19," said co-author Bria Coates, MD, Critical Care physician at Ann & Robert H. Lurie Children's Hospital of Chicago and Assistant Professor of Pediatrics at Northwestern University Feinberg School of Medicine. "Although protection was lower during the Omicron period, compared to the Delta period, even a moderate reduction in risk is important, because COVID-19 vaccines are not likely to be available for babies younger than 6 months old in the foreseeable future."

The study included infants younger than 6 months of age who were admitted to 30 pediatric hospitals in 22 states from July 1, 2021, to March 8, 2022.

Dr. Coates and colleagues found that most infants (90 percent) who needed intensive care due to COVID-19 infection were born to mothers who were not vaccinated during pregnancy.

Infants aged younger than 6 months old are at high risk for complications of COVID-19, including severe respiratory failure or death and account for a disproportionately high percentage of hospitalizations among those aged 0-4 years. This study included data on 537 babies who were hospitalized with COVID-19. Of those, 21 percent were admitted to the intensive care unit and 12 percent required mechanical ventilation, or extra help getting enough oxygen to the body, or vasoactive infusions. Two babies died because of COVID-19 and two required advanced life support that helps the body get enough oxygen; mothers of these babies were not vaccinated.

Researchers also found that effectiveness of maternal COVID-19 vaccination against COVID-19 hospitalization for babies was higher among women vaccinated after 20 weeks of pregnancy, versus early in pregnancy.

"While protection for the baby is important, it is critical to remember that COVID-19 vaccines protect women against severe illness during pregnancy and reduce complications from COVID-19," said Dr. Coates, who also is the Crown Family Research Scholar in Developmental Biology.

When considering the timing of COVID-19 vaccination during pregnancy, the CDC and professional medical organizations, like the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine, recommend COVID-19 vaccination as soon as eligible and at any point in pregnancy. The CDC recommends that women who are pregnant, breastfeeding, trying to get pregnant, or might become pregnant in the future get vaccinated and stay up to date with their COVID-19 vaccines.

https://www.sciencedaily.com/releases/2022/06/220624115417.htm

Screen time, alcohol, and poor sleep for girls: How the pandemic has impacted teens in Australia

June 6, 2022

Science Daily/University of Sydney

Australian teens had overall improvements in sleep over the two years and some improvements in dietary choices during lockdown, however these were offset by increases in already concerning levels of screen time and worrying trends of alcohol use and poor sleep among girls.

Led by the University of Sydney and published in BMJ Open today, the study adds important new data to the growing chorus of concern around the long-term impacts of COVID-19 on young people. It also emphasises the importance of tailoring support and interventions to address specific concerns and groups -- such as adolescent girls -- who appear to be most impacted.

"We know these lifestyle risk behaviours are common among young people, but we also know they are key predictors of chronic diseases later in life, such as cancer, cardiovascular disease and mental disorders," said lead author Dr Lauren Gardner, Research Fellow at the Matilda Centre for Research Excellence in Mental Health and Substance Use in the Faculty of Medicine and Health.

"It's important that we understand how to best support young Australians moving forward, regardless of the course of the pandemic, and invest in prevention and health promotion activities."

About the study

The research drew on self-reported longitudinal survey data from 983 Australian adolescents (average age 12.6 years at baseline) enrolled in the The Health4Life Study.

It analysed data over a two-year period from before (2019) to during the COVID-19 pandemic (2021) -- looking at the 'Big 6' health behaviours: diet, physical activity, recreational screen time, sleep and alcohol and tobacco use.

The researchers also examined if differences over time were associated with gender and lockdown status across three Australian states -- New South Wales, Queensland and Western Australia.

Key findings:

• Compared to pre-pandemic levels, there were increases in the prevalence of excessive recreational screen time (86% to 94%), insufficient fruit intake (20% to 30%), and increased alcohol (2% to 10%) and tobacco use (1% to 4%)*.

• Overall, the prevalence of insufficient sleep decreased over the two-year period (by 26%), regardless of lockdown status.

• Being in lockdown was associated with improvements in sugar sweetened beverage consumption (39% lower than those not in lockdown) and discretionary food intake (27% lower than those not in lockdown).

• For females, there was an increase in the prevalence of insufficient sleep (24% higher than males) and alcohol use* (134% higher than males).

• Although the prevalence of insufficient physical activity and insufficient vegetable intake did not change over time, nor were there differences based on lockdown status, these behaviours remain concerning, with 82% not achieving 60 minutes of moderate-to-vigorous physical activity per day and 84% not eating the recommended five serves of vegetables per day.

*The increase in alcohol and tobacco use over time was expected as the cohort aged and remained relatively low, however, the greater increase in alcohol use among females was unexpected.

"The Health4Life study gave us a unique opportunity to assess changes in key health behaviours in a large and geographically diverse sample. Due to Australia's state-based public health restrictions, approximately one-third of the sample was subjected to the Greater Sydney stay-at-home orders at the second time point, allowing us to look at how different levels of restrictions impacted these behaviours," said Dr Gardner.

Comparison to the international experience

Director of the Matilda Centre, Professor Maree Teesson said the new study reinforces other international research highlighting the varied impact of the COVD-19 pandemic across countries and within regions.

"The full extent of the impact of the pandemic on children and young people is being recognised internationally. This study is the first to examine those impacts on Australian teens," said Professor Teesson.

"We need a COVID recovery plan -- as proposed by Australia's Mental Health Think Tank -- that helps our young people get back on track for a healthier future."

"Supporting young people to improve or maintain positive health behaviours is important. Research such as this can help us start to understand the interplay between health behaviours and mental health to ensure we provide targeted interventions to those who need it the most."

https://www.sciencedaily.com/releases/2022/06/220606105622.htm

Exposure to great outdoors boosted mental health during pandemic

Study finds those who spent more time in green spaces reported less depression, anxiety

March 2, 2022

Science Daily/University of Colorado at Boulder

People exposed to more green space during the first year of the COVID-19 pandemic reported significantly less depression and anxiety, according to new University of Colorado Boulder research published March 2 in the journal PLOS One.

The study also found that, at a time when mental health problems soared due to financial woes, supply shortages and nonstop news coverage of the virus, people sought solace in the great outdoors, with one-third spending more time there than they did pre-COVID.

"This research shows how critical it is to keep parks and green spaces open in times of crisis," said senior author Colleen Reid, an assistant professor of geography in the Institute for Behavioral Science. "It also shows that, as a public health measure, more effort should be made to put in green spaces and make them accessible."

For the study, the authors presented about 1,200 Denver-area residents with a 30-minute survey gauging their mental health and their perceptions of green space near their home, including: how much there was, whether they could see it, whether it was accessible, how much they used it and its quality. They also collected aerial satellite imagery to objectively quantify greenery in respondents' neighborhoods.

The survey ran from November 2019 to January 2021.

Once COVID-19 emerged and lockdowns ensued, Reid added additional questions, providing a rare opportunity to also look at how the pandemic influenced mental health over time and what was most stressful about it.

"Not surprisingly, we found that the pandemic impacted mental health negatively," said co-author Emma Rieves, a master's student in the Department of Geography. "But we also found that green space could have a powerful protective effect, even at a time of such extraordinary stressors."

Supply shortages and job losses stressed people out

Surprisingly, the study found no association between being diagnosed with COVID and having poor mental health. But respondents reported that having symptoms, no diagnosis and no way to test was distressing.

Those who lost income or felt they were working in an unsafe environment were also more likely to be stressed or depressed, while the strongest source of mental health problems was a fear of supply shortages (including toilet paper and food).

People who spent a lot of time scrolling the internet looking at the news reported poorer mental health. In contrast, merely having abundant green space nearby, as measured by satellite images, was associated with lower depression scores.

To get the most benefit out of nearby green space, the study found, people had to get out and use it. Those who used green space most had significantly lower anxiety and depression.

"There are many dimensions of green space, and our study looked closely at how these dimensions impact mental health," said Rieves, noting that policymakers often rely solely on objective measures, like satellite images or proximity to parks when assessing whether to invest in more greenery in a community.

On a satellite image, Rieves points out, a large patch of greenery could actually be a weed-filled lot. A 'nearby park' could be on the other side of a busy highway.

"It's not just about being able to see trees from your home. The amount, quality and accessibility of that green space matters," said Rieves.

Many public agencies closed public green spaces, including neighborhood playgrounds and national parks, at the onset of the pandemic for fear that the virus could be easily spread via surfaces. Once parks reopened, with places like gyms, bars and churches still closed, Coloradans flocked to the outdoors: 33% of respondents reported spending more time in parks or on trails than the year before.

The 'biophilia hypothesis'

The study adds to a growing body of evidence suggesting that green space can have a measurable impact on health.

According to one theory, known as the 'biophilia hypothesis,' humans innately tend to seek connections with green spaces, where the calming environment influences stress hormones in a way that promotes healing and fends off disease.

"The idea is that we have evolved with nature, and only in the recent past have we been living in the concrete jungle," said Reid.

One famous 1984 study even found that when hospital patients had rooms with a window looking out on green space, their wounds healed faster and they required less pain medication than those looking out on a brick wall.

Reid cautioned that correlations between green space and health have been scrutinized, in part because people with higher incomes and, thus, better access to healthy food and health care may also be more able to afford to live near green spaces.

To address that, Reid's study took sociodemographic factors into account, along with the many unique circumstances that have emerged during COVID.

After controlling for all the factors, the benefits still remained clear: "Spend more time outside," Rieves said. "Pandemic or no pandemic, it's good for your mental health."

https://www.sciencedaily.com/releases/2022/03/220302150329.htm

COVID-19 vaccination boosts mental health along with immunity

February 15, 2022

Science Daily/Elsevier

Getting vaccinated for COVID-19 measurably improved the psychological well-being of participants in the Understanding Coronavirus in America study, a large longitudinal look at the impact of the pandemic on individuals in the United States. Vaccination was associated with declines in distress and perceived risks of infection, hospitalization, and death. The study, appearing in the American Journal of Preventive Medicine, published by Elsevier, validates the intuitive but previously unanswered questions of whether becoming vaccinated reduces perceived risks associated with COVID-19, and whether the reduction of these fears leads to improvements in mental health and quality of life.

"Our study documents important psychological benefits of vaccination beyond reducing the risk of severe illness and death associated with COVID-19," said lead investigator Jonathan Koltai, PhD, Department of Sociology, University of New Hampshire, Durham, NH, USA.

Psychologic distress and anxiety increased sharply across the population following the onset of the COVID-19 pandemic. Several factors contributed, such as widespread job and income loss, food insecurity, social isolation, caregiving burdens, substance abuse, and racialized discrimination. Depressive symptoms persisted and increased into 2021 for those experiencing an accumulation of stress exposures. Not surprisingly, many individuals are also experiencing anticipatory fears that contribute to rising mental health problems.

Data from a nationally representative study of 8,090 adults who were interviewed regularly between March 2020 and June 2021 revealed declines in COVID-related risk perceptions and psychological distress following vaccination. Specifically, adults who received at least one dose of the COVID-19 vaccine between December 2020 and June 2021 reported a 7% relative reduction in mental distress, as measured using the Patient Health Questionnaire 4 (PHQ-4) distress scores, from average levels in the survey period immediately prior to vaccination.

Reductions in distress were partially explained by declining risk perceptions following vaccination. Becoming vaccinated was associated with a 7.77 percentage point decline in perceived risk of infection, a 6.91 percentage point decline in perceived risk of hospitalization, and a 4.68 percentage point decline in perceived risk of death. Adjusting for risk perceptions decreased the vaccination?distress association by 25%.

These effects persisted and became stronger up to at least eight weeks following vaccination. It is noteworthy that while responses from vaccinated and never-vaccinated participants followed similar trends pre-vaccination, they significantly diverged post-vaccination. Becoming vaccinated made people feel safer in addition to being safer.

The impact of vaccination on mental health varied by race/ethnicity. The largest reductions in distress were observed among American Indians (AI) and Alaska Native (AN) individuals, who have suffered disproportionately from COVID-19. The breakout among racial/ethnic groups was proportional to the overall US population during the study period, with the highest rates of vaccination observed among Asian and Pacific Islanders, and the lowest rates of vaccination observed among Black participants.

With the rapid rise of the Omicron variant in late 2021 and early 2022, urgent measures are needed to increase vaccination rates and achieve vaccine equity, both locally and globally. These efforts need to be coupled with effective communication about the benefits, both physical and mental, associated with vaccination.

Dr. Koltai stressed, "To ensure these benefits are widely shared, efforts to increase vaccination and booster rates in early 2022 need to prioritize equitable distribution and access to vaccines."

https://www.sciencedaily.com/releases/2022/02/220215125454.htm

Study finds high levels of depression, anxiety among disabled people during COVID-19 pandemic

February 3, 2022

Science Daily/Oregon State University

A new study from Oregon State University confirms what many in the disabled community already know: People with disabilities have been experiencing high levels of depression and anxiety during the COVID-19 pandemic.

Social isolation was the main predictor for both depression and anxiety, said Kathleen Bogart, co-author on the study and an associate professor of psychology at OSU.

"We know that people with disabilities were more socially isolated before the pandemic, so for a variety of reasons, the pandemic has amplified that disparity," she said.

People with disabilities are often immunocompromised or have comorbidities that would cause more severe infection from COVID-19, requiring more strict isolation at home to avoid exposure to the virus.

The study, published in Rehabilitation Psychology, examined survey responses from 441 adults between October and December 2020 who self-identified as having a disability. In total, 61% of participants met the criteria for probable major depressive disorder and 50% for probable generalized anxiety disorder.

That's much higher than the pre-pandemic baseline among people with and without disabilities, Bogart said. Previous research in the field has found that about 22% of people with disabilities are diagnosed with depression during their lifetime. According to the Anxiety & Depression Association of America, in an average year, roughly 7% of all U.S. adults have major depressive disorder and 3% have generalized anxiety disorder.

Stigma was also a major predictor for depression and anxiety, particularly from conversations and policies around medical rationing where disabled people were essentially deemed a low priority for life-saving COVID resources. This translated into greater fear of catching the virus and needing medical care that might not be available, and therefore more social isolation, Bogart said.

"Especially early on in the beginning of the pandemic, there were explicit policies in place that disabled people would not be given priority to receive a ventilator or to receive even COVID tests when those were scarce," she said.

Medical practitioners were directed to focus resources on patients who were likely to have a "good quality of life" after COVID, but the health care system frequently underestimates the quality of life among disabled people, whether it be someone who uses a wheelchair or someone who has an intellectual disability, she said.

"Some of those policies thankfully got removed, though I think some are still in place," Bogart said. "But even when those policies don't exist, there are a lot of other more implicit ways that health care was difficult to access."

For example, at different points during the pandemic, hospitals and health care centers have delayed or canceled all "non-essential" health care to limit transmission of COVID within their facilities. This means that disabled people cannot access their regularly scheduled health care, including physical therapy or surgery, which can exacerbate their conditions.

Despite the surge in mental health issues, Bogart sees some hope in the study's findings: Social isolation and access to health care are points that can be addressed fairly easily, such as by connecting via Zoom and capitalizing on telehealth visits when possible. Several large disability organizations have been organizing virtual community events as well, which may be more accessible to some people than in-person events, depending on their disability.

"We know that social support is really beneficial; what's interesting is perceived isolation or perceived social support is much more important than the actual concrete number of friends in your social network," she said. "It's all about whether someone perceives their support to be adequate."

Home visits and in-home assistance are also crucial for making health care accessible and safe for people with disabilities when the practitioner needs to physically treat or examine them, Bogart said.

And within telehealth, Bogart said health care systems can improve accessibility by providing automatic captioning for people who are deaf or hard of hearing, providing sign language interpreters and making platforms that blind patients can navigate, as well.

https://www.sciencedaily.com/releases/2022/02/220203161117.htm

New mothers twice as likely to have post-natal depression in lockdown

May 11, 2021

Science Daily/University College London

Almost half (47.5%) of women with babies aged six months or younger met the threshold for postnatal depression during the first COVID-19 lockdown, more than double average rates for Europe before the pandemic (23%), finds a new study led by UCL researchers.

Women described feelings of isolation, exhaustion, worry, inadequacy, guilt, and increased stress. Many grieved for what they felt were lost opportunities for them and their baby, and worried about the developmental impact of social isolation on their new little one.

Those whose partners were unable or unavailable to help with parenting and domestic tasks, particularly where they were also dealing with the demands of home schooling, felt the negative impacts of lockdown most acutely.

Researchers surveyed 162 mums in London between May and June 2020 using a unique social network survey designed in response to lockdown. Participants listed up to 25 people who were important to them and shared who they had interacted with and how, whether in person, by phone, video call or messaging on social media.

The women also reported on their well-being with researchers basing depression ratings on the Edinburgh Postnatal Depression Scale, the most commonly used tool. This allowed them to capture the full range of mothers' social interactions, as well as their mental health.

The findings are published today (11 May 2021) in the journal Frontiers in Psychology.

The more contact new mums had with people, either remotely or face-to-face, the fewer depressive symptoms they reported, suggesting reduced social contact during lockdown may have increased the risk of postnatal depression.

However, where women had maintained some face-to-face contact with family members, they were actually more likely to have depressive symptoms than women who saw fewer of their relatives. Researchers think this reflects family responding to mums who were struggling with their mental health, potentially breaking lockdown rules to help them.

Many mothers felt that lockdown created a 'burden of constant mothering' without anyone around to help, and that while virtual contact (video calls/phone calls/texts/social media messages) helped, it was still inadequate. Virtual contact meant women had to actively ask for help, because friends and family couldn't see them struggling, which they felt amplified the stresses of motherhood.

Dr Sarah Myers (UCL Anthropology) said: "Caring for a new baby is challenging and all new mothers suffer some level of mental, physical and emotional exhaustion. Low social support is one of the key risk factors for developing postnatal depression. Social distancing measures during lockdown created so many barriers to having practical help and meaningful support from others in the weeks and months after their baby's arrival, leading many new mothers to feel totally overwhelmed.

"It really does take a village to raise a child, especially in a crisis when everyone is dealing with increased demands, stresses and significant life events. Our survey shows that lockdowns leave new mothers more vulnerable to postnatal depression, and that digital solutions might help but they are not the answer. Policy makers must take this into account as we continue to deal with COVID-19, for the sake of mums, babies and whole families."

Not everything new mums experienced as a result of lockdown was negative. Some felt it 'protected' family time, leading to better bonding. Other benefits included partners being around more to co-parent and help out than if the UK had not been in lockdown.

Dr Emily Emmott (UCL Anthropology) said: "New mothers with more than one child were hardest hit, left to deal with newborns on top of multiple demands like home schooling. First-time mothers often felt cheated out of precious time spent together with their babies and family or friends, making coming to terms with the change of identity and isolation that new mothers often feel even harder.

"But, where partners were at home more because of lockdown, and able to share the relentless tasks and household chores or take care of existing children, new mums felt the benefits. Some reported that it helped everyone develop closer relationships and that the family benefited overall from spending this time together. This should also be food for thought when we look at support for parents with new babies, not just in a pandemic."

Comments from new mothers surveyed about their experiences included: "It has definitely made me more anxious -- am I doing enough for my baby, is she ok, is she healthy and happy, should I be doing more, do people think I'm a good mother? Much of this is because it's hard to communicate online."

A first-time mother said, "I feel I'm making it up as I go along and have no one to guide me," while another mum said, "I worry that my child isn't getting the development they deserve as they are not getting enough stimulus."

One mum described how, "We haven't had anyone come over to give us a break since before lockdown and it's exhausting."

Another said: "I think lockdown has made me feel like I'm not a person in my own right anymore. Not having anyone to hold him or to help out a bit makes me feel it's all me and it's a lot of pressure, which I can resent. I feel like I don't have any time to rest." While another mum said, "I am an exhausted mum not able to concentrate on either of my children and this is taking a toll on everyone."

https://www.sciencedaily.com/releases/2021/05/210511123619.htm

Physical inactivity linked to more severe COVID-19 infection and death

Surpassed only by advanced age and organ transplant as a risk factor, large study shows

April 13, 2021

Science Daily/BMJ

Physical inactivity is linked to more severe COVID-19 infection and a heightened risk of dying from the disease, finds a large US study published online in the British Journal of Sports Medicine.

Patients with COVID-19 who were consistently inactive during the 2 years preceding the pandemic were more likely to be admitted to hospital, to require intensive care, and to die than were patients who had consistently met physical activity guidelines, the findings show.

As a risk factor for severe disease, physical inactivity was surpassed only by advanced age and a history of organ transplant.

Several risk factors for severe COVID-19 infection have been identified, including advanced age, male sex, and certain underlying medical conditions, such as diabetes, obesity, and cardiovascular disease.

But physical inactivity is not one of them, even though it is a well known contributory risk factor for several long term conditions, including those associated with severe COVID-19, point out the researchers.

To explore its potential impact on the severity of the infection, including hospital admission rates, need for intensive care, and death, the researchers compared these outcomes in 48,440 adults with confirmed COVID-19 infection between January and October 2020.

The patients' average age was 47; nearly two thirds were women (62%). Their average weight (BMI) was 31, which is classified as obese.

Around half had no underlying conditions, including diabetes, COPD, cardiovascular disease, kidney disease, and cancer; nearly 1 in 5 (18%) had only one; and almost a third (32%) had two or more.

All of them had reported their level of regular physical activity at least three times between March 2018 and March 2020 at outpatient clinics. This was classified as consistently inactive (0-10 mins/week); some activity (11-149 mins/week); or consistently meeting physical activity guidelines (150+ mins/week).

Some 7% were consistently meeting physical activity guidelines;15% were consistently inactive, with the remainder reporting some activity.

White patients were most likely to consistently meet physical activity guidelines (10%), followed by Asian patients (7%), Hispanic patients (6%) and African-American patients (5%).

Some 9% of the total were admitted to hospital; around 3% required intensive care; and 2% died. Consistently meeting physical activity guidelines was strongly associated with a reduced risk of these outcomes.

After taking account of potentially influential factors, such as race, age, and underlying medical conditions, patients with COVID-19 who were consistently physically inactive were more than twice as likely to be admitted to hospital as those who clocked up 150+ minutes of physical activity every week.

They were also 73% more likely to require intensive care, and 2.5 times more likely to die of the infection.

And patients who were consistently inactive were also 20% more likely to be admitted to hospital, 10% more likely to require intensive care, and 32% more likely to die of their infection than were patients who were doing some physical activity regularly.

This is an observational study, and as such, can't establish cause. The study also relied on patients' own assessments of their physical activity. Nor was there any measure of exercise intensity beyond the threshold of 'moderate to strenuous exercise' (such as a brisk walk).

But the study was large and ethnically diverse. And the researchers point out: "It is notable that being consistently inactive was a stronger risk factor for severe COVID-19 outcomes than any of the underlying medical conditions and risk factors identified by [The Centers for Disease Control] except for age and a history of organ transplant.

"In fact, physical inactivity was the strongest risk factor across all outcomes, compared with the commonly cited modifiable risk factors, including smoking, obesity, diabetes, hypertension [high blood pressure], cardiovascular disease and cancer."

They conclude: "We recommend that public health authorities inform all populations that short of vaccination and following public health safety guidelines such as social distancing and mask use, engaging in regular [physical activity] may be the single most important action individuals can take to prevent severe COVID-19 and its complications, including death.

"This message is especially important given the increased barriers to achieving regular [physical activity] during lockdowns and other pandemic restrictions."

https://www.sciencedaily.com/releases/2021/04/210413194036.htm

COVID-19 pandemic may have increased mental health issues within families

April 13, 2021

Science Daily/Penn State

When the COVID-19 pandemic hit in early 2020, many families found themselves suddenly isolated together at home. A year later, new research has linked this period with a variety of large, detrimental effects on individuals' and families' well-being and functioning.

The study -- led by Penn State researchers -- found that in the first months of the pandemic, parents reported that their children were experiencing much higher levels of "internalizing" problems like depression and anxiety, and "externalizing" problems such as disruptive and aggressive behavior, than before the pandemic. Parents also reported that they themselves were experiencing much higher levels of depression and lower levels of coparenting quality with their partners.

Mark Feinberg, research professor of health and human development at Penn State, said the results -- recently published in the journal Family Process -- give insight into just how devastating periods of family and social stress can be for parents and children, and how important a good coparenting relationship can be for family well-being.

"Stress in general -- whether daily hassles or acute, crisis-driven stress -- typically leads to greater conflict and hostility in family relationships," Feinberg said. "If parents can support each other in these situations, the evidence from past research indicates that they will be able to be more patient and more supportive with their children, rather than becoming more harsh and angry."

Feinberg added that understanding what can help parents maintain positive parenting practices, such as a positive coparenting relationship, is key for helping protect children during future crises -- whether those crises are pandemics, economic shocks or natural disasters.

While cross-sectional studies have suggested there has been a negative impact of the pandemic on families, the researchers said this study is one of the first to measure just how much these factors have changed within families before and after the pandemic hit.

According to the researchers, previous research has found that periods of financial stress, such as the Great Depression and the 2008 recession, have led to higher levels of parent stress, mental health problems and interparental conflict, which can all lead to more harsh, and even abusive, parenting.

When the COVID-19 pandemic hit, Feinberg said it led to not only financial stress within families, but also problems related to being isolated together, issues managing work and childcare, and general fear related to the sudden health threat that was poorly understood.

"When the pandemic hit, like many people, I was very anxious and worried," Feinberg said. "I saw the tensions and difficulties my daughter and I were having being home together 24/7. So, when I realized that our existing studies and samples of families gave us an opportunity to learn something about how families would cope during the crisis, my team and I moved into action."

For the study, the researchers used data from 129 families, which included 122 mothers and 84 fathers, with an average of 2.3 children per family. The parents answered an online questionnaire that asked them about their depressive symptoms, anxiety, the quality of their relationship with their coparent, and externalizing and internalizing behavior they observed in their children, among other measures.

Because the participants were part of a longer study measuring these factors over prior years, the researchers already had data on these parents and children from before the pandemic.

The researchers found that parents were 2.4 times more likely to report "clinically significant" high levels of depression after the pandemic hit than before. They were also 2.5 times and 4 times more likely to report externalizing and internalizing problems, respectively, in their children at levels high enough that professional help might be needed.

Feinberg said that while it makes sense that families would experience these difficulties, he was shocked at the magnitude of the declines in well-being.

"The size of these changes are considered very large in our field and are rarely seen," Feinberg said. "We saw not just overall shifts, but greater numbers of parents and children who were in the clinical range for depression and behavior problems, which means they were likely struggling with a diagnosable disorder and would benefit from treatment."

Feinberg put the size of the declines in parent and child well-being in perspective by pointing out that the increase in parents' levels of depressive symptoms in the first months of the pandemic was about twice as large as the average benefit of antidepressants.

The researchers said that as the risk of future pandemics and natural disasters increases with the effects of climate change, so will the likelihood of families facing stressful conditions again in the future

"Getting ready for these types of crises could include helping families prepare -- not just by stocking up on supplies, but also by improving family resiliency and psychological coping resources," Feinberg said. "In my view, that means providing the kinds of family prevention programs we've been developing and testing at the Prevention Research Center for the past 20 years."

For example, Feinberg explained that their research shows that the Family Foundations program helps new parents develop stronger capacities for cooperation and support in their relationship with each other as coparents, which is a key dimension of family resiliency.

Feinberg said future research will examine whether families who went through Family Foundations or other programs were more resilient, maintained better family relationships, and experienced smaller declines in mental health during the pandemic.

Jacqueline Mogle, Jin-Kyung Lee, Samantha L. Tornello, Michelle L. Hostetler, Joseph A. Cifelli and Sunhye Bai, all at Penn State; and Emily Hotez, University of California, also participated in this work.

The National Institute of Child Health and Development and The Huck Institutes of the Life Sciences at Penn State helped support this research.

https://www.sciencedaily.com/releases/2021/04/210412142720.htm

High rates of depression, anxiety, PTSD worldwide among health workers during COVID-19

Sixty five-study analysis includes research published in English and Chinese

March 10, 2021

Science Daily/PLOS

A new systematic review of 65 studies from around the world involves a total of 97,333 health care workers and finds that 1 in 5 have experienced depression, anxiety, and/or PTSD during the ongoing COVID-19 pandemic. Yufei Li, Nathaniel Scherer, and colleagues at the London School of Hygiene & Tropical Medicine, U.K., present these findings in the open-access journal PLOS ONE on March 10.

The pandemic has posed significant challenges for health care workers, with many fearing for their own safety while facing a high workload and limited psychological support. Previous analyses of data from multiple studies have revealed high rates of depression, anxiety, and PTSD among health care workers during the pandemic. However, those reviews did not adequately address the many relevant studies conducted in China, where the first COVID-19 outbreak occurred.

To address that gap, Li, Scherer, and colleagues carried out a systematic search of studies in both English and Chinese that were conducted from December 2019 to August 2020 and addressed prevalence of mental disorders in health care workers. They identified 65 suitable studies from 21 countries, involving a total of 97,333 health care workers.

By pooling and statistically analyzing data from all 65 studies, the researchers estimated that 21.7 percent of the health care workers involved in the studies have experienced depression during the pandemic, 22.1 percent anxiety, and 21.5 percent PTSD. Studies conducted in the Middle East showed the highest pooled rates of depression (34.6 percent) and anxiety (28.9 percent).

These findings suggest that the COVID-19 pandemic has significantly impacted the mental health of health care workers. For comparison, the World Health Organization estimates that 4.4 percent of the entire world population experience depression, and 3.6 percent experience anxiety disorders, including PTSD. However, those estimates were determined through different methods and prior to the pandemic.

Nonetheless, the authors note, the new findings could help inform policy and initiatives to provide urgently needed psychological support to health care workers.

The authors add: "This systematic review and meta-analysis provides, to date, the most comprehensive synthesis of depression, anxiety and PTSD prevalence amongst health care workers during the COVID-19 pandemic, with the unique inclusion of publications in both English and Chinese."

https://www.sciencedaily.com/releases/2021/03/210310150402.htm

COVID-19 pandemic severely impacts mental health of young people

March 22, 2021

Science Daily/University of Surrey

The Covid-19 pandemic severely impacted the mental health of young people, with increased levels of clinical depression being identified, a new study published in the journal Psychiatry Research reports. A decrease in alcohol consumption was also identified amongst young people during the pandemic.

During this unique study researchers from the University of Surrey surveyed 259 young people pre- pandemic (autumn 2019) and in the midst of initial lockdown measures (May/June 2020) on their levels of depression, anxiety, wellbeing, alcohol use and sleep quality.

Researchers found evidence of a substantial impact on the mental health of these young adults due to the Covid-19 pandemic, with a significant rise in depression symptoms and a reduction in overall wellbeing during lockdown compared to the previous autumn. Levels of clinical depression in those surveyed were found to have more than doubled, rising from 14.9 per cent in autumn 2019 to 34.7 per cent in May/June 2020.

Sleep quality was not seen to decline in the overall sample but, importantly, a correlation was seen between the rise in depression and lower sleep quality under lockdown. Also of concern, researchers identified a significant shift towards 'eveningness' (a preference to go to sleep and wake later), which has previously been associated with higher levels of anxiety and a greater prevalence of minor psychiatric disorders.

Interestingly, despite reports of rising worldwide sales of alcohol during the first lockdown, researchers identified a significant decrease in alcohol consumption amongst the group that could be attributed to social restrictions in place during this period. Researchers were encouraged by this finding as it suggests that young people were not using alcohol as a coping strategy during that time.

Findings from this study highlight the substantial impact of the Covid-19 pandemic on young people's mental health. The link to sleep quality could help inform strategies to support their wellbeing as the Covid-19 situation continues to evolve.

Dr Simon Evans, Lecturer in Neuroscience at the University of Surrey, said: "For many years there has been a rise in the number of young people experiencing problems with their mental health, and it is concerning to find that this has been significantly exacerbated due to Covid-19. Supporting the mental health of young people and ensuring they can access the support they need is vital to ensure their overall wellbeing. As social restrictions continue in response to the pandemic, it is crucial that we take steps to protect their mental health."

https://www.sciencedaily.com/releases/2021/03/210322112907.htm

Insomnia, disrupted sleep, and burnout linked to higher odds of severe COVID-19

Each 1-hour increase in sleep associated with 12% lower odds of infection among clinicians

March 22, 2021

Science Daily/BMJ

Insomnia, disrupted sleep, and daily burnout are linked to a heightened risk of not only becoming infected with coronavirus, but also having more severe disease and a longer recovery period, suggests an international study of healthcare workers, published in the online journal BMJ Nutrition Prevention & Health.

Every 1-hour increase in the amount of time spent asleep at night was associated with 12% lower odds of becoming infected with COVID-19, the findings indicate.

Disrupted/insufficient sleep and work burnout have been linked to a heightened risk of viral and bacterial infections, but it's not clear if these are also risk factors for COVID-19, say the researchers.

To explore this further, they drew on the responses to an online survey for healthcare workers repeatedly exposed to patients with COVID-19 infection, such as those working in emergency or intensive care, and so at heightened risk of becoming infected themselves.

The survey ran from 17 July to 25 September 2020, and was open to healthcare workers in France, Germany, Italy, Spain, the UK, and the USA.

Respondents provided personal details on lifestyle, health, and use of prescription meds and dietary supplements plus information on the amount of sleep they got at night and in daytime naps over the preceding year; any sleep problems; burnout from work; and workplace exposure to COVID-19 infection.

Some 2884 healthcare workers responded, 568 of whom had COVID-19, ascertained either by self-reported diagnostic symptoms and/or a positive swab test result.

Infection severity was defined as: very mild -- no or hardly any symptoms; mild -- fever with or without cough, requiring no treatment; moderate -- fever, respiratory symptoms and/or pneumonia; severe -- breathing difficulties and low oxygen saturation; and critical -- respiratory failure requiring mechanical assistance and intensive care.

The amount of reported nightly sleep averaged under 7 hours, but more than 6. After accounting for potentially influential factors, every extra hour of sleep at night was associated with 12% lower odds of COVID-19 infection.

But an extra hour acquired in daytime napping was associated with 6% higher odds, although this association varied by country.

Around 1 in 4 (137;24%) of those with COVID-19 reported difficulties sleeping at night compared with around 1 in 5 (21%;495) of those without the infection.

And 1 in 20 (5%;28) of those with COVID-19 said they had 3 or more sleep problems, including difficulties falling asleep, staying asleep, or needing to use sleeping pills on 3 or more nights of the week, compared with 65 (3%) of those without the infection.

Compared with those who had no sleep problems, those with three had 88% greater odds of COVID-19 infection.

Proportionally more of those with COVID-19 reported daily burnout than did those without the infection: 31 (5.5%) compared with 71 (3%).

Compared with those who didn't report any burnout, those for whom this was a daily occurrence were more than twice as likely to have COVID-19. Similarly, these respondents were also around 3 times as likely to say that their infection was severe and that they needed a longer recovery period.

These findings held true, irrespective of the frequency of COVID-19 workplace exposure.

This is an observational study, and as such, can't establish cause. And the researchers acknowledge several limitations to their study.

These include subjective assessment of exposure levels, sleep issues, and infection severity, all of which may have been incorrectly remembered. And the sample included only cases of very mild to moderately severe COVID-19.

By way of an explanation for their findings, the researchers note: "The mechanism underlying these associations remains unclear, but it has been hypothesized that lack of sleep and sleep disorders may adversely influence the immune system by increasing proinflammatory cytokines and histamines."

And they point to studies linking burnout to a heightened risk of colds and flu as well as long term conditions, such as diabetes, cardiovascular disease, musculoskeletal disease and death from all causes.

"These studies have suggested that burnout may directly or indirectly predict illnesses by occupational stress impairing the immune system and changing cortisol levels," they write.

And they conclude:"We found that lack of sleep at night, severe sleep problems and high level of burnout may be risk factors for COVID-19 in frontline [healthcare workers]. Our results highlight the importance of healthcare professionals' well-being during the pandemic."

"This study spotlights an often neglected area of wellbeing: the need for quality sleep and re-charge time to prevent burnout and its consequences. From an occupational and lifestyle medicine perspective, a better understanding of the effects of shift work and sleep is essential for the wellbeing of healthcare staff and other key workers," comments Dr Minha Rajput-Ray, Medical Director of NNEdPro Global Centre for Nutrition & Health, which co-owns the journal with BMJ.

"Disruptions to the sleep-wake cycle can affect metabolic, immune and even psychological health," she adds. "And sleep deprivation can make calorie dense foods, higher in fat, sugar and salt, more appealing, particularly during times of stress and/or difficult shift patterns, all of which takes a toll on overall health and wellbeing."

https://www.sciencedaily.com/releases/2021/03/210322195837.htm

Move your body for five minutes every hour to counteract lockdown inactivity

March 22, 2021

Science Daily/King's College London

A study which looked at activity levels before and during the COVID-19 pandemic has found lockdown restrictions significantly reduced light activity associated with socialising and work.

The study, published recently in BMJ Neurology and led by King's College London, examined how activity levels changed in study participants with muscular dystrophy and other inheritable myopathies. The sample included people with a range of physical abilities, from highly independent to assisted mobility, including 41 wheelchair users, who are often underrepresented in research. However, the authors say the findings are likely to be relevant to adults of various abilities and backgrounds because many people have lost their usual daily routine during lockdown.

The study is unique because it used accelerometers to measure physical activity before and during lockdown as part of an ongoing longitudinal physical activity study from 2019 to 2020. The accelerometers measured activity intensity, frequency and time in vigorous, moderate, light and inactive categories.

Researchers found there was a significant reduction in daily activity intensity during lockdown. Before lockdown, participants did a mean of 84.5 minutes per day of light activity and had a relatively low frequency of hourly movement. During lockdown, light activity reduced by a mean of 25 minutes per day and frequency of hourly movement reduced by a median of 11%. Moderate and vigorous activity did not change significantly during lockdown, but this might be explained by low baseline levels in this group.

In lockdown, the reduction in light activity time and frequency of movement was explained by restrictions on going to work, leisure pursuits and socialising. This light activity within daily routine is not exercise-focused so it can be difficult for individuals to detect these subtle light activity losses. However, light activity and regular movement throughout the day are associated with improved health outcomes for everyone, regardless of health conditions.

Sarah Roberts-Lewis, the study lead and a Neurological Physiotherapist at King's College London, said: "Even people who don't do much exercise have been impacted by lockdown inactivity. During COVID-19 lockdown, our study detected an extra hour per day of inactivity in disabled and independent adults with neuromuscular diseases. Moving less is detrimental to health. Reduced activity can be especially harmful for those with neuromuscular conditions, disabilities or advanced age."

"The reduction in light activity measured in this study is likely to be similar for anybody whose daily routine has been restricted by lockdown. Based on our findings, we suggest people move their bodies for 5 minutes each hour during the day. Additionally, spend 30 minutes each day doing some extra light activity, like yoga or chair exercises. The World Health Organisation activity guidelines state 'every move counts'; they provide suggestions about light activites suitable for all abilities. Simple changes can help with reconditioning during and after lockdown."

https://www.sciencedaily.com/releases/2021/03/210322112904.htm

COVID-19 pandemic impacts mental health worldwide

Physical distancing measures to mitigate viral spread increased anxiety

March 18, 2021

Science Daily/Columbia University's Mailman School of Public Health

A study conducted at Columbia University Mailman School of Public Health reports a high global prevalence of both depression and anxiety during the COVID-19 pandemic and shows how implementation of mitigation strategies including public transportation and school closures, and stay-at-home orders impacted such disorders. The results are published in Psychological Medicine.

"Our research found an elevated global prevalence of these mental health issues during COVID-19 and also revealed there was a wide variance in each at the region- and country-level," said, João Castaldelli-Maia, MD, PhD, NIDA-INVEST Postdoctoral Fellow in the Department of Epidemiology, and lead author. In particular, Asia (most studies came from China) presented lower levels of both anxiety and depression, compared to the other regions of the world. Closure of public transportation increased levels of anxiety, whether it was two weeks or four weeks past the passage of closure enactment, especially in Europe."

Using an end date of July 29th, 2020, the researchers analyzed data from Pubmed, MEDLINE, Web of Science, and medRxiv, among other databases, for depression and anxiety prevalence. They also reviewed the Oxford Covid-19 Government Response Tracker for the containment and closure policies indexes; and the Global Burden of Disease Study for previous levels of depression and anxiety. The WHO database which includes COVID literature for studies published by the same date was also used.

In total, 226,638 individuals were assessed within 60 included studies. Global prevalence of both depression and anxiety during the COVID-19 pandemic were 24 percent and 21 percent, respectively. Asia with rates of 18 percent for each, and China especially, had the lowest prevalence of both disorders. Regarding the impact of mitigation strategies on mental health -- whether it was public transportation closures, school closings, workplace closures, cancellation of public events, or restrictions on gathering -- only public transportation closures increased prevalence of anxiety, especially in Europe.

Castaldelli-Maia and colleagues found a 21 percent global prevalence of anxiety. Asia had lower levels of anxiety (18 percent) compared to other regions of the world (29 percent). In this case, Europe did not differ from Asia and other regions of the world. Again, a subgroup analysis at the country-level showed that China had a lower prevalence of anxiety at 15.5 percent compared to all other countries at 26 percent.

"Our study confirms how critical it is to investigate levels of mental health disorders and the possible impacts of social distancing measures on mental health outcomes, according to Silvia Martins, MD, PhD, associate professor of Epidemiology at Columbia Mailman School, and senior author. "Mental health concerns should not be viewed only as a delayed consequence of the COVID-19 pandemic, but also as a concurrent epidemic."

Within the subgroup of Asian countries, estimates of depression prevalence ranged from 15 percent to 20 percent. When comparing the prevalence of depression in the pre-and post-COVID-19 eras, the estimates ranging from 1.3-3.4 percent, are demonstrably larger after the initiation of COVID-19.

Depression was observed among 26 percent of the population in Europe, and among 39 percent in other non-Asia regions of the world. A further analysis showed that China had a lower prevalence of depression, 16 percent compared with 29 percent in other countries.

Similarly, the prevalence of anxiety, as reported in the subgroup of Asian countries is higher post-COVID-19. Rates of anxiety prior to COVID-19 ranged from 2.1 to 4.1 percent vs. 18 percent in the present study. Increases in anxiety can be observed in countries outside Asia and Europe (3 to 7 percent vs. 29 percent).

"The lower levels of depression and anxiety that we found in Asian countries could be culture-dependent," observes Martins.

The effect of public transportation closures on anxiety levels points to the importance of these systems to global populations, particularly the results in Europe but not in Asia. "These findings could be linked to the fact that Europe has a more effective and implemented public transport network on average, making Europeans depending more on public transportation than people in Asian countries," noted Martins.

"The COVID-19 pandemic, and the resulting physical distancing measures to mitigate viral spread, has certainly impacted population mental health worldwide, and the high prevalence of mental health disorders is a considerable concern during the COVID era," said Castaldelli-Maia. "These results have important implications for policymakers and show the urgent need for the healthcare sector to increase support now for prevention and early intervention of depression and anxiety."

https://www.sciencedaily.com/releases/2021/03/210318085630.htm

Pandemic got you down? A little nature could help

Spending time in nature can help ease stressful feelings, researchers find

February 18, 2021

Science Daily/University of Connecticut

Having trouble coping with COVID?

Go take a hike. Literally.

Researchers have long been aware of the positive impact of a connection with nature on psychological health and, according to a new study published in the journal Personality and Individual Differences, the pandemic hasn't decreased the power of nature to improve mental well-being.

"Thinking about the natural world in an interconnected and harmonious way corresponds to improved psychological health, no matter where you are," says Brian W. Haas, the lead author of the new study and an associate professor in the Behavioral and Brain Sciences Program at the University of Georgia.

Haas and his collaborators -- Fumiko Hoeft, a professor of psychological sciences at UConn and director of UConn's Brain Imaging Research Center; and Kazufumi Omura, faculty of Education, Art and Science at Yamagata University in Japan -- used a survey in America and Japan to measure worldviews on nature as well as how much the pandemic impacted people's lives, and their current psychological health.

The survey sought to gauge whether the participants had a worldview in harmony with nature -- being in tune or connected with the natural world, or a worldview of mastery over nature -- the belief that people have the ability to control the natural world. They also reported on their stress levels and were asked if the COVID-19 pandemic has affected them personally or impacted their employment or finances.

The researchers found that, while participants in general report greater stress levels during the pandemic, individuals with a harmony-with-nature worldview were coping better regardless of whether they lived in Japan or in the United States.

"Clearly there's great need for study as relates to the pandemic, not just now during COVID, but also of previous pandemics and for possible future pandemics," says Hoeft. "I feel like this is a really great lesson, and a moment for us to really appreciate that things like our relationship with nature do matter and make an impact on more tangible things, like our mental health, which we often forget."

The researchers found that the difference between the two cultures, however, became apparent when looking at individuals with a mastery-over-nature worldview.

"We found that the Americans who believed that humans are, and should be, the masters of the natural world did not tend to cope well during the pandemic," Haas says. "While this was not the case in Japan."

Rather, in Japan, having a mastery-over-nature worldview was not correlated with poor coping. The researchers suggest the difference might be rooted in the concept of naïve dialecticism -- the acceptance or tolerance of contradiction.

"In other cultures outside of the United States, people tend to be more comfortable with contradiction; in other cultures, it is generally more accepted to possess conflicting ideas within your mind at the same time," Haas says. "But in the United States, it's not. We can apply this concept to nature and the current global pandemic. For instance, if I hold a view that I am the master of the natural world, and then a global pandemic happens, this is a clear natural disaster. If I believe that I am the master of the natural world, then surely I would never allow a natural disaster to happen. These concepts are inconsistent with one another, and a consequence of inconsistency is often negative mood."

While the study offers only a snapshot view of just two cultures, Haas believes other cultures would likely demonstrate a similar positive association with a harmony-with-nature worldviews, predicting that "it's likely a universal phenomenon."

Both Haas and Hoeft say that, in an increasingly virtual and technology driven world, taking a moment to appreciate nature has clear benefits regardless of where you live.

"In Japanese, there's this word called 'forest-bathing,'" Hoeft says. "It's basically when you go out into nature, and enjoy being surrounded by trees. It's usually for forests, but you go walking and it's supposed to refresh you. People often talk about how they went out 'forest bathing.' I love thinking about these kinds of old phrases -- do they have some real impact or real scientific background in the end? And I think this is one of them where this really does have a connection. There is some scientific truth behind this."

"Think about taking a step away from Zoom for a moment and taking a walk and listening to the birds chirp," Haas says. "I mean, just the benefit of that, and understanding that we have a role in this natural world, and we're part of it. I think that's really intuitive and it's obvious, but I think it's also really, really important. We're showing very convincingly with empirical data that, during a very difficult time like we are in now, that it's important to do these things to maintain your psychological health."

https://www.sciencedaily.com/releases/2021/02/210218140115.htm

Make-up of gut microbiome may influence COVID-19 severity and immune response

Imbalances in type and volume of bacteria may also be implicated in 'long COVID'

January 11, 2021

Science Daily/BMJ

The variety and volume of bacteria in the gut, known as the microbiome, may influence the severity of COVID-19 as well as the magnitude of the immune system response to the infection, suggests research published online in the journal Gut.

Imbalances in the make-up of the microbiome may also be implicated in persisting inflammatory symptoms, dubbed 'long COVID', the findings suggest.

COVID-19 is primarily a respiratory illness, but the evidence suggests that the gut may also have a role.

As the gut is the largest immunological organ in the body and its resident microbes are known to influence immune responses, the researchers wanted to find out if the gut microbiome might also affect the immune system response to COVID-19 infection.

They therefore obtained blood and stool samples and medical records from 100 hospital inpatients with laboratory-confirmed COVID-19 infection between February and May 2020 and from 78 people without COVID-19 who were taking part in a microbiome study before the pandemic.

The severity of COVID-19 was classified as mild in the absence of x-ray evidence of pneumonia; moderate if pneumonia with fever and respiratory tract symptoms were detected; severe if patients found it very difficult to breathe normally; and critical if they needed mechanical ventilation or experienced organ failure requiring intensive care.

To characterise the gut microbiome, 41 of the COVID patients provided multiple stool samples while in hospital, 27 of whom provided serial stool samples up to 30 days after clearance of SARS-CoV-2, the virus responsible for COVID-19.

Analysis of all 274 stool samples showed that the make-up of the gut microbiome differed significantly between patients with and without COVID-19, irrespective of whether they had been treated with drugs, including antibiotics.

COVID patients had higher numbers of Ruminococcus gnavus, Ruminococcus torques and Bacteroides dorei species than people without the infection.

And they had far fewer of the species that can influence immune system response, such as Bifidobacterium adolescentis, Faecalibacterium prausnitzii and Eubacterium rectale.

Lower numbers of F. prausnitzii and Bifidobacterium bifidum were particularly associated with infection severity after taking account of antibiotic use and patient age.

And the numbers of these bacteria remained low in the samples collected up to 30 days after infected patients had cleared the virus from their bodies.

COVID-19 infection prompts the immune system to produce inflammatory cytokines in response. In some cases, this response can be excessive ('cytokine storm'), causing widespread tissue damage, septic shock, and multiorgan failure.

Analysis of the blood samples showed that the microbial imbalance found in the COVID patients was also associated with raised levels of inflammatory cytokines and blood markers of tissue damage, such as C-reactive protein and certain enzymes.

This suggests that the gut microbiome might influence the immune system response to COVID-19 infection and potentially affect disease severity and outcome, say the researchers.

"In light of reports that a subset of recovered patients with COVID-19 experience persistent symptoms, such as fatigue, dyspnoea [breathlessness] and joint pains, some over 80 days after initial onset of symptoms, we posit that the dysbiotic gut microbiome could contribute to immune-related health problems post-COVID-19," they write.

This is an observational study, and as such, can't establish cause, added to which the gut microbiome varies widely among different populations, so the changes observed in this study may not be applicable to other COVID patients elsewhere, caution the researchers.

But they point to mounting evidence showing that gut microbes are linked to inflammatory diseases within and beyond the gut.

And they conclude: "Bolstering of beneficial gut species depleted in COVID-19 could serve as a novel avenue to mitigate severe disease, underscoring the importance of managing patients' gut microbiota during and after COVID-19."

https://www.sciencedaily.com/releases/2021/01/210111190135.htm