Depression as a Risk Factor for Severe COVID-19 Infection

Peter Gillespie ’25

Figure 1: Covid-19 is a highly contagious respiratory virus that has caused millions of deaths and has strained the healthcare system

Covid-19 has been at the forefront of concern for many since the pandemic struck, especially for patients with risk factors for severe diseases if infected by Covid-19. Respiratory and cardiovascular disease, old age, hypertension, and diabetes have already been established as high risk factors for severe Covid-19 infection. However, recent research from Dr. Sean Clouston and his colleagues has identified a new risk factor for Covid-19: depression. Dr. Clouston analyzed the pre-morbidities of 1,375 hospital admittances for Covid-19 during the first two months of the pandemic in Suffolk County where many New York City frontline workers reside. The researchers investigated the association between specific pre-morbid conditions and resulting mortality. Chi-square test analysis was used to determine a significant association between pre-morbidities and mortality, and Cox proportional hazards models predicted the risk of mortality relative to specific variables. Given the concern of how factors such as old age and ventilator use may increase the risk of mortality, multivariable Cox proportional hazards regression analysis was performed to account for the potential influence of these factors.

The researchers identified various factors that increase risk for mortality, with a prominent risk being a history of depression. While it is important to note that lacking comorbidities did not indefinitely reduce one’s risk of mortality, factors such as old age, a history of heart failure, diabetes, and chronic obstructive pulmonary disorder along with a history of depression significantly increased one’s risk of mortality. The researchers postulate that, since pro-inflammatory signaling molecules (such as Interleukin-6) increase in patients with depression, Covid-19 likely exacerbates the adverse outcomes brought on by an excess of pro-inflammatory molecules. This association between depression and increased risk of mortality was especially prevalent in males. Additionally, the correlation between depression and increased mortality could be observed in older patients, suggesting that depression was its own contributing factor independent of the influences of old age. 

Although the study was limited to one location and did not consider the possible effects of race, ethnicity, and potential disparities, it provides compelling evidence that a history of depression may heighten one’s risk for Covid. Identifying those individuals at increased risk for severe infection is a crucial proactive measure to prevent severe disease, especially as many begin to return to work with Covid-19 still looming.

Works Cited:

[1] S. Clouston, B. Luft, and E. Sun, Clinical risk factors for mortality in an analysis of 1375 patients admitted for covid treatment. Scientific Reports 11, 1-7 (2021). doi: 10.1038/s41598-021-02920-w.

[2] Image retrieved from:


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