Childhood Adversity and COVID-19 Outcomes: Findings from the UK Biobank

ABSTRACT Objectives To investigate the association between childhood adversity and COVID-19-related hospitalization and COVID-19-related mortality in the UK Biobank. Design Cohort study. Setting United Kingdom. Participants 151,200 participants in the UK Biobank cohort who had completed the Childhood Trauma Screen, were alive at the start of the COVID-19 pandemic (01-10-2021), and were still active in the UK Biobank when hospitalization and mortality data were most recently updated (11-2021). Main outcome measures COVID-19-related hospitalization and COVID-19-related mortality. Results Higher self-reports of childhood adversity were related to greater likelihood of COVID-19-related hospitalization in all statistical models. In models adjusted for age, ethnicity, and sex, childhood adversity was associated with an OR of 1.227 of hospitalization (95% CI=1.153 to 1.306, Childhood Adversity z =6.49, p <0.005) and an OR of 1.25 of a COVID-19 related death (95% CI=1.11 to 1.424, Childhood Adversity z =3.5, p <0.005). Adjustment for potential confounds attenuated these associations, although associations remained statistically significant. Conclusions Childhood adversity was significantly associated with COVID-19-related hospitalization and COVID-19-related mortality after adjusting for sociodemographic and health confounders. Further research is needed to clarify the biological and psychosocial processes underlying these associations to inform public health intervention and prevention strategies to minimize COVID-19 disparities. Trial registration Work Completed under UK Biobank Project ID 92699 (“ Associations between COVID-19 Symptoms & Stressful Life Experiences ”). Summary Prompts What is already known on this topic Disparities in COVID-19 outcomes are driven by numerous health and sociodemographic risk factors Childhood adversity is associated with lifelong physical health disparities and early mortality No known studies to date have examined the association between childhood adversity and COVID-19 mortality and morbidity What the study adds In the UK Biobank, childhood adversity was significantly associated with COVID-19-related hospitalization and COVID-19-related mortality. For both morbidity and mortality, these links were seen in statistical models adjusted for important sociodemographic and physical health confounders. How this study might affect research, practice or policy Modifiable and more proximal psychosocial factors may impact adult health outcomes, including COVID-19-related mortality and hospitalization Adversity may relate to depression, self-concept, or self-regulation, cascading from childhood experiences to the outcomes that we investigated here. Pinpointing these processes may allow for policy and interventions to lessen the negative impact of COVID-19 in those that have suffered childhood adversity.