Hair samples capture Covid’s stressful toll
Anxiety, depression and other mental health disorders have all increased during the pandemic, but what impact does this have on our physical health? The work of Professor Kavita Vedhara and her team looks at how Covid stress could be affecting not just our minds but our bodies too.
When Britain was plunged into lockdown at the start of the Covid pandemic in March 2020, uncertainty was rife. Fear and anxiety levels rose and no-one knew how long it would be before normality returned.
It was in those early days that Kavita Vedhara, Professor in Applied Psychology, and her School of Medicine team realised there was a huge opportunity to study human behaviour in unprecedented circumstances, but that they would need to act fast to get the insights they needed.
With the help of Senior Research Fellow Kieran Ayling, PhD student Ru Jia, Professor in Medical Statistics Carol Coupland, Dr Adam Massey, a former student and Director of Cortigenix, and Professor Trudie Chalder at King’s College London, a large-scale study was designed within days, and within a month over 3,000 people had been recruited.
Building on the team’s existing expertise, they decided to look not only at the psychological impacts of the lockdown, but also the physical effects by measuring the levels of the stress hormone cortisol in hair samples. The group had previously used this approach to measure stress in women undergoing IVF.
Ru said: “At the very beginning, it struck me that we would be able to measure stress without coming into close contact with people. We had the ability to carry out a significant study at just the right time, when a lot of other research had to be put on hold.”
Kavita said: “In the very first group call we had during lockdown we were talking about the mental health impact and stress, and all of the emotions that we were all too familiar with, and Ru said ‘We should really be measuring cortisol in people, shouldn't we?’
“We had this conversation on the Tuesday and by the Friday, Ru, Kieran and myself had pretty much worked up the protocol.”
"We had the ability to carry out a significant study at just the right time, when a lot of other research had to be put on hold."
Forging ahead without funding, they used every avenue they could – including a strong social media presence – to recruit to the study and had an overwhelming response.
Kavita said: “I think what we achieved in four weeks is a huge testament to the efforts of Ru and Kieran, and the wider network that we created, pulling together 3,000 people from across the UK who wanted to say something about how they were feeling.
“I also think it’s worth emphasising that so much important work happens in this way, without funding. A lot of time is wasted trying to get funding when, in reality, what happens is that groups of academics just get on with the job. Think about the amazing work that’s come out of Oxford in terms of developing the vaccine. Of course in their case they were very fortunate to get the funding that was needed to turn today’s Covid-19 vaccines into reality, and thank goodness they did!”
The initial phase of the study covered the first 12 weeks of lockdown, with participants being asked to complete a short online survey about their wellbeing and to provide a hair sample. This was repeated several months later as the UK emerged from this first lockdown.
Kieran said: “We knew it would be really interesting to see what was happening in real time. We knew people were experiencing anxiety and stress, but what was that doing to their bodies and their health?
“The trouble was when we were in lockdown there was so much you couldn’t measure. We couldn’t take blood samples, we couldn’t take saliva samples. All the labs were closed, but because of our previous work on measuring cortisol in hair we knew we had the expertise to do something remotely that would still be useful.”
Exposure to high levels of cortisol over a longer period of time can have an impact on the body’s immune system, making a person more susceptible to illness and inflammation.
The team were able to collect samples at the start of the first lockdown and again several months later as restrictions eased. Because of the way cortisol is deposited in hair, this meant that the first sample captured people’s cortisol levels in the months before the first lockdown. In contrast, the second sample focused on cortisol levels in the lockdown months in particular.
The group have only recently completed the measurement of cortisol in these hair samples and the results will be submitted for publication soon. However, what they found from their surveys was that the people most affected by stress, depression and anxiety during the pandemic tended to be younger people and women. But they also observed that there was a lot of variation between people in terms of how distressed they were, with people who worried less about Covid-19, who felt less lonely, and who were able to experience more positive emotions appeared to be somewhat protected.
Much of the early data produced by the group was shared with Public Health England (PHE), to help inform its response to the pandemic – with Kavita and the team producing specific analyses on the different response in men and women, as well as in different occupations including frontline NHS workers.
Kavita said: “PHE were very engaged with what we were doing. We were informing policy and that was really exciting for us because it the sort of work that we do is usually quite upstream from policy’.”
The team have gone on to become involved in wider Covid studies happening across the university including a study looking at the impact of psychological and behavioural factors on vaccine effectiveness, a study into the mental health impact of the pandemic on students and have developed a website to give people the support and information they need to make an informed choice on having a Covid-19 vaccine
"The pandemic has thrown up so many opportunities to understand humans and human behaviour and I would say we’ve embraced it."
“The work we are doing has led us to work closely with people with expertise in statistics, mathematical modelling, big data, basic science, public health and behavioural science,” said Kavita.
“The pandemic has thrown up so many opportunities to understand humans and human behaviour and I would say we’ve embraced it.
“What we’ve achieved has been through the incredible hard work of a team of people who love science, and who are interested in questions, and who have allowed themselves to be liberated from the normal bureaucracy that controls the way we usually operate.”
Kavita Vedhara, Kieran Ayling and Ru Jia
Professor in Applied Psychology Kavita Vedhara, Senior Research Fellow Dr Kieran Ayling and PhD student Ru Jia are all based in the School of Medicine
MedRxix March 2021, Holly Knight, Ru Jia, Kieran Ayling, Kavita Vedhara et al.,Understanding and Addressing Vaccine Hesitancy in the Context of COVID-19: Development of a Digital intervention
MedRxix December 2020, Ru Jia et al., Experiences of the COVID-19 pandemic: cross-sectional analysis of risk perceptions and mental health in a student cohort
Public Health December 2020 Ru Jia, Kieran Ayling, Kavita Vedhara et al., Young people, mental health and COVID-19 infection: the canaries we put in the coal mine
BMJ Open September 2020, Ru Jia et al., Mental health in the UK during the COVID-19 pandemic: cross-sectional analyses from a community cohort study
BMJ Open May 2021: Norina Gasteiger, Kavita Vedhara et el., Depression, anxiety and stress during the COVID-19 pandemic: results from a New Zealand cohort study on mental well-being