Suicide attempts among college students hospitalized for COVID-19

Background: Suicide is the second leading cause of death among U.S. college students. Past pandemics have been linked to increases in suicide risk, but little is known about how suicide risk relates to COVID-19 symptoms or hospitalizations. Methods: We analyzed data from the Fall cohort of the 2020-2021 Healthy Minds Study, a cross-sectional, web-based survey of undergraduate and graduate students in the U.S. (N = 16,315). Logistic regression was used to test for associations between COVID-19 infections, hospitalizations, and symptoms severity, and suicide-related outcomes. Results: Suicidal ideation was reported by n = 2190 (13.4%), plans by n = 885 (5.4%), and attempts by n = 209 (1.3%). The prevalence of each suicide-related outcome measure was greater among those reporting COVID-19 symptoms/diagnosis and among those with greater COVID-19 symptom severity, with a drastically greater prevalence of suicide attempts among those who were hospitalized for COVID-19, odds ratio (95% confidence interval) = 9.43 (3.87-22.95). Among respondents with suicidal ideation, 53.8% of those hospitalized for COVID-19 also made a suicide attempt, compared to 8.9% of non-infected respondents with past-year ideation. Limitations: Limitations include the use of cross-sectional data and retrospective self-report measures, which may be subject to recall biases. The response rate was low but typical of online surveys conducted during the COVID-19 pandemic. Conclusions: Hospitalization for COVID-19 may be an underestimated risk factor for suicide attempts. While mechanisms remain unclear, these data suggest that college students hospitalized for COVID should be screened for suicidal thoughts and behaviors subsequent to discharge, particularly if they have pre-existing suicidal ideation.