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More and more, researchers are discovering that trauma early in childhood can get under the skin in ways that can last a lifetime. A Pitt study analyzing a massive dataset shows one new way these adverse experiences manifest: in worse COVID-19 outcomes as an adult.

“These findings highlight how trauma early in life can have long-lasting impacts on health decades later,” said , an assistant professor of psychology in the Kenneth P. Dietrich �鶹��ý of Arts and Sciences and a researcher in Pitt’s .

Having difficult experiences in childhood is linked to negative mental health outcomes, but can also affect a person’s physiology, including the stress system and inflammation — it’s this latter link that drove Hanson to wonder if such experiences might cause worse COVID outcomes, too.

“We know that COVID-19 is related to excessive hospitalization and death in the U.K. and in the United States,” he said. “And there’s emerging research finding that facing adversity, abuse or neglect early in life could have sizeable effects on physical health.”

To test that idea, Hanson turned to the UK Biobank, a massive database of the traits and genetic predispositions of volunteers from the United Kingdom. Working with information provided by 151,200 adults, the team found those with early adverse experiences were 12%-25% more likely to be hospitalized or die due to COVID. That link persisted, albeit less strongly, when the researchers controlled for other factors linked to adversity, like chronic health conditions.

Childhood adversity, in other words, adds another layer of risk on top of those factors, meaning that understanding early experiences is necessary to fully understand someone’s vulnerability to COVID-19 as an adult. “If you’re just measuring depression or current health conditions or current socioeconomic status, you may be missing a good bit of the picture that still contributes to their risk,” Hanson said.

The team — including Pitt psychology PhD student Isabella Kahhale, research assistant Dorothea Adkins and clinical research coordinator Kristen O’Connor — published the study Nov. 1 in the .

The study is the first to find a link between COVID-19 outcomes and early childhood adversity, and while the results are modest, even just a few percentage points difference in COVID outcomes can have a substantial effect on public health at the society level, Hanson said.

Moreover, the study was conducted in Great Britain, a country with universal health care and a substantial social safety net, and the study’s sample leaned more affluent and educated than the population as a whole. As the team follows up by examining the same phenomenon in the United States, Hanson expects to find similar, or even more severe, lifelong impacts of childhood adversity — including those that may last long after an infection.

“I wouldn’t be surprised if some of the excess mortality in the States is because people who have suffered adversity here may have more chronic health problems that then escalate into their COVID outcomes or long COVID,” he said.

There are two broad lessons to be drawn from the work, Hanson said. Those who experienced adversity in childhood may need more targeted support via health interventions like offering Paxlovid, an antiviral used to treat COVID-19, and encouraging vaccinations. The results are also an indication that we need to look out for the kids who are growing up now. ��

“This continues to illustrate to me that we should be supporting families that may be marginalized and have high levels of stress,” he said. “If we don’t support them, this is just another way that the consequences of those experiences and that lack of support may come back to impact us as a society.”

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Photography by Tom Altany