A matched case-control study on the attributable risk of CES-D positivity to the incidence of COVID-19 breakthrough infections.

Objectives: To investigate whether the Center for Epidemiologic Studies Depression Scale (CES-D) positivity (16 and above) is a risk factor for breakthrough infections of coronavirus disease 2019 (COVID-19), a matched case-control study was conducted among hospital employees. Methods: Participants were matched based on known risk factors, including serum SARS-CoV-2 anti-S antibodies. A multivariate logistic regression analysis was conducted with CES-D score measured at baseline as the explanatory variable and the presence of breakthrough infection after a specified period as the outcome variable, and gender, age, and other covariates were included. Results: Logistic regression analysis showed that CES-D positivity was significantly associated with the breakthrough COVID-19 infections (odds ratio 4.393; 95% confidence interval, 1.318-14.642, P=0.016). Conclusions: An increase in the number of hospital employees with CES-D positivity during the pandemic might contribute to a rise in breakthrough infections. It is considered necessary to alleviate people's stress levels through the enhancement of mental health care interventions, complementing infection control measures.