- Diurnal cortisol secretions play a role in the presence of environmental stressors
- CAR alone was found to not be statistically significant in determining total perceived stress during confinement
  - However, CAR along with BRCS (which is the brief resilient coping score) was found to be statistically significant in predicting total perceived stress (p = 0.035) when confined
    - BRCS is more effective alone than both combining both (p=0.017)
      - These factors come together to relate confinement and stress during the pandemic



Measurements/Scores Taken on Cortisol and Stress During Confinement 

Diurnal cortisol secretions (AUCg) and the cortisol awakening response (CAR) play a role in determining how susceptible someone is to the SARS-CoV-2 virus.

Michigan State University

Cortisol is a steroid hormone that plays a role in metabolism and the immune response. (i.e. It is released when stress levels are increased or blood-glucose levels are low)

Cortisol

Baliyan, S., Cimadevilla, J. M., de Vidania, S., Pulopulos, M. M., Sandi, C., & Venero, C. (2021). Differential Susceptibility to the Impact of the COVID-19 Pandemic on Working Memory, Empathy, and Perceived Stress: The Role of Cortisol and Resilience. Brain Sciences, 11(3), 348.

Differential Susceptibility to the Impact of the COVID-19 Pandemic on Working Memory, Empathy, and Perceived Stress: The Role of Cortisol and Resilience

- Those with COVID-19 showed a greater acute cortisol stress response compared to those who did not contract COVID-19.
- There is a positive association between cortisol levels and mortality
   - If cortisol levels increased, then the likelihood of death would increase
- Patients did not show adrenal insufficiency immediately, which is caused by low cortisol levels, but adrenal insufficiency will mostly increase a while after the onset of the virus
- In a study, it was found that when cortisol levels were greater than 744 nmol/L, there was a decrease in survival probability over a span of 42 days

Cortisol Concentrations and COVID-19 Mortality

- The HADS scale was used to determine levels of anxiety and depression
- It was found that there is a statistically significant relationship between the HADS score and cortisol levels
  - As levels of depression and anxiety increased, cortisol levels also increased
- COVID-19 Patients who had passed away had higher serum cortisol levels compared to the COVID-19 patients that survived
- Stress increases one’s susceptibility to respiratory tract infections, making patients more vulnerable to getting a cold
  - The immune cells become unable to regulate inflammation
- As tissues become less sensitive to cortisol due to high levels of stress, it becomes more difficult to regulate stress levels

Anxiety and Cortisol Levels in COVID-19 Patients

SARS-CoV-2 negatively impacts the cortisol stress response. Corticosteroid therapy is efficient in treating severe COVID-19


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