Is the psychological well-being of a population associated with COVID-19 related survival?

  1. Frederik Feys

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Abstract

OBJECTIVE

Immunological mind-body research suggests mental health may also be important in the COVID-19 pandemic. This study aimed to investigate the potential influence of mental health as a protective factor for COVID-19 related mortality in the general population. The second goal was to examine this among populations of countries most affected by COVID-19 related mortality.

METHODS

Data sources were the Global Burden of Disease report 2017 and publicly reported situational reports of COVID-19. We described variables; calculated the spearman’s correlation coefficient, calculated the percentage of the variability of the data that is explained by the association. We explored inter-relationships among other variables: aged 70 or older, cardiovascular disease, obesity and diabetes. A correlation matrix with plotted scatter matrix diagrams was produced.

RESULTS

Across 181 countries, the mean total COVID-19 related survivors per million was 999,949 (sd = 125), median = 999,993. The variable had a lognormal distribution; the mean mentally healthy per 100,000 was 85,411 (sd = 1,871), median = 85,634. The test of normality resulted in p-value < 0.001. Correlation of mentally healthy per 100,0000 and totals of COVID-19 related survivors was ϱ s = 0.29 (n = 181, 95% CI 0.16–0.43). The variance explained by the relation between mental healthy and totals of COVID-19 related survivors was 8.4% (2.6–18.5%). Across countries most affected by COVID-19 related mortality ϱ s = 0.49 (n = 45, 0.28–0.70), explaining 24.2% (7.7–49.3%).

CONCLUSION

A weak association was found between the psychological well-being of a population and COVID-19 related survival. This relationship explained between 2.6 and 18.5% of COVID-19 related survival. For countries most affected by COVID-19 related death, this association was moderate and explained between 7.7 and 49.3%. Confirmation of these important observational findings is needed with future individual patient data research.

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  1. Version published to 10.1101/2020.06.05.20123018v2 on medRxiv
  2. ScreenIT

    SciScore for 10.1101/2020.06.05.20123018: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Strengths and weaknesses: This is the first study to assess the potential association between mental healthy populations and their chance of COVID-19 related survival. Thanks to the Global Burden of Disease study, we could cover mental health of 181 (93%) countries worldwide. All analyses were underpinned by scientific rationale and were performed using appropriate statistical methods. The study’s internal validity is limited. The countries in the dataset do not come from a random sample. The reported p-values and confidence intervals are therefore not strictly valid, but give an idea of the uncertainty surrounding the values found. Mental health data stemmed from 2017, so they do not describe prevalences today. However, we assumed that prevalences for mental disorders and substance use have remained fairly constant up to this day in most countries and therefore remain a valuable proxy for the current mental health rates. Still, the COVID-19 pandemic has lowered mentally healthy populations in some countries (18–20); but exactly how more data from other countries would alter our findings remains to discover. Attribution of death to a specific cause is often challenging and definitions of “COVID-19 death” vary across countries and sometimes even change within countries over time. Overall, some COVID-19 deaths may be missed, and others may be overcounted. Clearly, the external validity of findings to individual countries is limited. Findings are observational and should be inte...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

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  3. Version published to 10.1101/2020.06.05.20123018v1 on medRxiv