Psychological, disparate effects of the pandemic detailed by recent research

More than a third of surveyed U.S. adults reported having mental or behavioral health problems in late June, according to a report in the Aug. 14 MMWR. Of 5,470 respondents, 30.9% reported symptoms of anxiety disorder or depressive disorder, 26.3% reported symptoms of trauma- and stressor-related disorder related to COVID-19, 13.3% had started or increased substance use to cope with stress or emotions related to the pandemic, and 10.7% had seriously considered suicide in the preceding 30 days. At least one of these problems was reported by more than half of people who were ages 18 to 44 years, essential workers, or unpaid caregivers for adults, among other categories. “The public health response to the COVID-19 pandemic should increase intervention and prevention efforts to address associated mental health conditions. Community-level efforts, including health communication strategies, should prioritize young adults, racial/ethnic minorities, essential workers, and unpaid adult caregivers,” said the report.

Disparities in the effects of the pandemic were also highlighted by an analysis of hospitalizations for COVID-19 by race and ethnicity, published as a research letter by JAMA Internal Medicine on Aug. 17. It looked at 48,788 hospitalizations in 12 states. White patients made up a smaller percentage of hospitalizations than of the population in all 12, while Black patients' hospitalizations exceeded their population percentage in all 12. Ten of 11 states reporting data for Hispanic patients showed they had an excess rate of hospitalization. Six of the 10 states with data on Asian patients showed a lower than proportionate rate of hospitalization for this group. American Indian and Alaskan Native hospitalizations were only reported by eight states, several of which showed substantially higher hospitalization rates in these groups.

Race and ethnicity were not associated with risk of death from COVID-19, but obesity was in a large Californian health system, according to a study published by Annals of Internal Medicine on Aug. 12. Among the studied 6,916 patients with COVID-19, there was a J-shaped association between body mass index and mortality, with patients with extreme obesity having more than double the risk of death of those with normal body weight. “This risk was most striking among those aged 60 years or younger and men,” the authors noted, suggesting that the results provide a target for early intervention. An accompanying editorial noted that obesity is a common but difficult-to-change risk factor, so measures to avoid coronavirus infection should be recommended to at-risk patients.

An inactivated vaccine showed promise against the virus in phases 1 and 2 of a Chinese trial, according a preliminary report published by JAMA on Aug. 13. Healthy adults ages 18 to 59 years were randomized to either multiple doses of the vaccine or placebo. There was a low rate of adverse reactions, most commonly injection-site pain, and antibody testing at 14 days found immunogenicity in vaccinated patients. An accompanying editorial notes that these are the first data on a protein immunogen COVID-19 vaccine candidate and provide “important interim safety, tolerability, and immune response results” that will need to be confirmed in the ongoing phase 1/2 trial and subsequent phase 3 trial.