Poor stress resilience in adolescence predicts higher risk of severe COVID-19 and other respiratory infections: A prospective cohort study of 1.4 million Swedish men.

Publication date: Dec 01, 2024

To investigate the associations between stress resilience in late adolescence and later risk of severe COVID-19 and other lower respiratory infections. A secondary aim was to examine potential confounding between low cardiorespiratory fitness (CRF) and stress resilience in relation to respiratory infection. We conducted a registry-based cohort study of 1. 4 million Swedish men, undergoing military conscription between 1968 and 2005. All were assessed by a psychologist for stress resilience, receiving a score between 1 and 9. The outcomes were hospitalization or death due to COVID-19 from March 2020 to September 2021 and hospitalization due to bacterial or viral pneumonia from conscription until January 2020. A secondary aim was to examine potential confounding between low cardiorespiratory fitness (CRF) and stress resilience in relation to respiratory infection. Poor stress resilience in late adolescence is associated with later risk of severe lower respiratory infections. Using a high resilience score as the reference, the hazard ratio (95 % CI) for death due to COVID-19 for the lowest scores was 1. 49 (1. 01-2. 18) adjusted for CRF and other confounders. The corresponding adjusted hazard ratios for hospitalization due to bacterial pneumonia were 2. 28 (2. 03-2. 57) and for viral pneumonia 1. 92 (1. 33-2. 79). No significant interaction was seen between stress resilience and CRF in the analysis. Poor stress resilience is a prospective factor for severe COVID-19 as well as for bacterial and viral respiratory pneumonia endpoints, independent of CRF. These findings imply an effect of late adolescent stress resilience on the immune system later in life.

Concepts Keywords
Fitness Adolescent
Late Adult
Pneumonia Cardiorespiratory Fitness
Psychologist Cardiorespiratory fitness
Swedish COVID-19
COVID-19
Hospitalization
Humans
Lower respiratory infection
Male
Military Personnel
Prospective Studies
Registries
Resilience, Psychological
Respiratory Tract Infections
Risk Factors
SARS-CoV-2
Stress resilience
Stress, Psychological
Sweden
Young Adult

Semantics

Type Source Name
disease MESH COVID-19
disease MESH respiratory infections
drug DRUGBANK Corticorelin
disease MESH infection
disease MESH death
disease MESH viral pneumonia
disease MESH bacterial pneumonia
disease MESH pneumonia
pathway REACTOME Immune System
disease MESH Stress Psychological

Original Article

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