The impact of asthma on mental health & wellbeing during COVID-19 lockdown

Introduction

The global SARS CoV2 pandemic resulted in social isolation measures with unintended negative impacts, particularly on mental health. We hypothesised that people with asthma are likely to be more vulnerable to worse mental health during lockdown.

Methods

We examined COVID-19 surveys (completed April/May 2020), nested within two generations of the Avon Longitudinal Study of Parents and Children (ALSPAC): index-generation ALSPAC-G1 (n= 2942, mean age=28) and the parent’s generation ALSPAC-G0 (n=3737, mean age=59). We used Poisson and logistic regression models to estimate the effect of asthma on wellbeing, anxiety and depression, and factors related to COVID-19 and lockdown. Models were adjusted for validated pre-pandemic measures of mental health and socio-economic factors.

Results

Asthma was associated with a 13% increase in depression score in ALSPAC-G1 (p=0.005) and 15% increase in ALSPAC-G0 (p=0.05) compared to participants without asthma, anxiety scores increased by 14% in ALSPAC-G1 (p=0.005) and by 16% in ALSPAC-G0 (p=0.02). Asthma was associated with a similar increase of anxiety and depression scores during COVID-19 in both generations (Z test p values >0.80).

Discussion

People with asthma have worse mental health & wellbeing during lockdown compared to people without asthma. Although the effect of asthma on mental health is of similar magnitude between the generations, younger participants with asthma declined to lower levels of mental health despite reporting less symptoms, COVID-19 infection and self-isolation. This has important implications given repeated lockdowns. Young people with asthma should be closely monitored and supported to mitigate the impact of lockdown on their mental health.

Key Messages

What is the question?

What is the impact of asthma on mental health & wellbeing during COVID-19 pandemic?

What is the bottom line?

People living with asthma report worse wellbeing, anxiety and depression in lockdown compared to those without asthma, the effect is not entirely explained by pre-existing mental health problems, physical symptoms or COVID-19 infections.

Why read on?

Young people living with asthma are more likely to report concerns about susceptibility to COVID 19 and job security. The negative impact of asthma on length of self-isolation, suspected COVID and symptoms appears greater in older people with asthma.