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Increases in stress hormone levels in a UK population during the COVID-19 pandemic: A prospective cohort study

Jia, Ru; Ayling, Kieran; Coupland, Carol; Chalder, Trudie; Massey, Adam; Nater, Urs; Broadbent, Elizabeth; Gasteiger, Norina; Gao, Wei; Kirschbaum, Clemens; Vedhara, Kavita


Research Fellow

Professor of Medical Statistics

Trudie Chalder

Adam Massey

Urs Nater

Elizabeth Broadbent

Norina Gasteiger

Wei Gao

Clemens Kirschbaum

Professor in Applied Psychology


Background: Research suggests that psychological factors may influence vulnerability to SARS-CoV-2 infection, although the mechanisms are unclear. Purpose: We examined whether the hypothalamic-pituitary-adrenal axis may be a possible mechanism, by measuring the relationship between indices of psychological distress and cortisone in hair (hairE) in a UK cohort during the COVID-19 pandemic. Methods: Participants (N = 827) provided two 3 cm hair samples over a 6-month period between April-September 2020. Samples reflected hairE in the 3 months prior to the collection date. Results: HairE in the first samples (T1: commenced April 2020) did not differ significantly from pre-pandemic population norms. However, hairE in the second samples (T2: commenced July 2020) were significantly higher than T1 and pre-pandemic population norms, with a 23% increase between T1 and T2. Linear regressions, controlling for age and gender, demonstrated that at both timepoints, hairE levels were greatest in people with a history of mental health difficulties. In addition, stress reported at T1 predicted greater hairE at T2 and a greater change in hairE between T1 and T2. Conclusions: These findings demonstrate that during the COVID-19 pandemic hairE was substantially elevated across a large community cohort, with greatest levels in those with a history of mental health difficulties and greatest changes in those reporting greatest levels of stress early in the pandemic. Further research is required with verified SARS-CoV-2 outcomes to determine whether the HPA axis is among the mechanisms by which a history of mental health difficulties and stress influence SARS-CoV-2 outcomes.


Jia, R., Ayling, K., Coupland, C., Chalder, T., Massey, A., Nater, U., …Vedhara, K. (2023). Increases in stress hormone levels in a UK population during the COVID-19 pandemic: A prospective cohort study. Psychoneuroendocrinology, 148, Article 105992.

Journal Article Type Article
Acceptance Date Nov 24, 2022
Online Publication Date Dec 7, 2022
Publication Date 2023-02
Deposit Date Dec 2, 2022
Publicly Available Date Dec 7, 2022
Journal Psychoneuroendocrinology
Print ISSN 0306-4530
Electronic ISSN 1873-3360
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 148
Article Number 105992
Keywords Biological Psychiatry; Psychiatry and Mental health; Endocrine and Autonomic Systems; Endocrinology; Endocrinology, Diabetes and Metabolism
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