Psyche and Covid-19: First results of the South Tyrol study are available

A section of the Covid-19 study, carried out across the country in the summer, addresses the psychological effects associated with the spread of Covid-19. The first results are now available and they show how important tests are, because a large proportion of those who tested positive did not consider themselves infected.

The study is a joint project of the South Tyrolean statistical institute ASTAT, the European Academy (EURAC), the institute for general medicine, the psychological service of the health district Brixen and the department for health. Over 800 people took part in the psychological part of the study and thus provided valuable information on the corona pandemic and its effects on the psyche.

Self-assessment of Covid-19 infection is insufficient

The preliminary evaluation of the psychological aspects shows that people cannot assess whether or not they have been infected with the new type of coronavirus.

“The human judgment in this regard largely corresponds to the guessing probability,” says the head of the psychological part of the study, Roland Keim. On the one hand, this is due to the fact that around 30 percent show no symptoms at all and, on the other hand, the symptoms are unspecific or cannot be correctly assigned by those affected. After all, around three quarters of the actually positive test subjects mistakenly believe that they were not infected at all or not at all with the SARS-CoV-2 virus. These are hardly any more for the subjects who actually tested negative.

This means that people often lull themselves into a false sense of security and thus run the risk of infecting others with the virus unnoticed. In light of these results, being completely ignorant of the broadcast is likely to be the rule rather than the exception.

Relationship between emotional stress and Covid-19 infection

Another interesting result: those who tested positive and negative do not differ in their specific fear of Covid-19. However, there is a statistically significant difference in terms of general anxiety, depression and stress between subjects who tested positive for Covid-19 and negative subjects who tested Covid-19: the subjects who tested positive were significantly more depressed, anxious and stressed than those who tested negative. This difference is not due to possible gender differences, age differences, knowledge of the infection, prolonged duration of illness, loss of job, the increased presence of chronic physical illnesses or quarantine measures. Most of the test subjects also seem to have coped well with the quarantine in psychological terms.

Neither the depression nor the anxiety nor the stress values ​​differ in subjects in quarantine from those who were not in quarantine. In fact, none of the test subjects who tested positive were in hospital treatment. Most of the cases had a mild to asymptomatic course. In principle, it is conceivable that this increased emotional burden is a specific consequence of the viral infection with the novel coronavirus. Similarly, a new, as yet unpublished Irish study has shown that more than half of patients at a Covid-19 outpatient clinic suffer from prolonged fatigue syndrome.

Contrary to this hypothesis, the test persons in the South Tyrol study report no deterioration in their physical or mental health, with a significantly milder overall outcome. Conversely, it cannot be ruled out that increased emotional stress increases the likelihood of infection with this virus. The latter has been demonstrated experimentally with harmless cold viruses and is in principle also seen as a possibility for this virus by the same research group. This could, among other things, explain why some close family members are infected if the same viral exposure is suspected, while others are not. The reason for this is seen to be the complex interplay between emotions and the immune system. In addition to the studies mentioned, there are also experimental results from animal experiments, information from epidemiological studies in various chronic diseases or from experimental studies on wound healing in psychological stress.

Whether psychological stress tends to increase the likelihood of infection or, conversely, the consequences of a past infection and which biological mechanisms are involved, would have to be clarified in a follow-up investigation.

Social factors and Covid-19 infection

On average, people with a Covid 19 infection stated that they were statistically significantly more likely to live in a larger household (χ2 p <0.03) and with their own parents (,2 p = 0.03) and, on average, spend more free time outside the home (χ2 p <0.05), to have a distance of one meter or less with several people at work (χ2 p <0.01), and they also report a greater diversity of the social network (tp <0.05).

In addition, it is comparatively irrelevant whether it was stated that they live in a larger apartment block or in a single-family house, or whether they belong to an association or a religious community. The information on the number of hours worked per week outside one’s own home, the type of means of transport used for work and leisure, the duration of the journey, regular contact with pets, the specific fear of Covid-19 or the presence of children in the household also show no differences between Covid- 19 subjects tested positive and negative.

Overall, these first results should be assessed with great caution, since statistical relationships do not yet provide any information about causality. For example, it cannot be ruled out that the psychological stress is caused by other variables that have not yet been recorded but are systematically related to Covid-19. Although the differences in terms of psychological stress between Covid-19 positives and negatives are statistically significant, the psychological stress is generally mild.

It seems all the more important to examine these aspects more closely in terms of causality in a follow-up study. The data from this survey is currently being statistically analyzed more precisely by the South Tyrolean institutions involved and the Institute for Advanced Studies at the University of Pavia.
Regardless of the suspected causality, these results show that with Covid-19, even in the case of mild courses, psychological concomitants must be considered.

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