Researchers are investigating the effect of COVID-19 lockdown on loneliness and cortisol levels
Researchers are investigating the effect of COVID-19 lockdown on loneliness and cortisol levels

Researchers are investigating the effect of COVID-19 lockdown on loneliness and cortisol levels

A recent study posted to medRxiv* Preprint server assessed the impact of social isolation and loneliness during the lockdown of coronavirus disease 2019 (COVID-19).

Examination: Loneliness and daily cortisol levels during COVID-19 lockdown: the roles of life situation, relationship status and relationship quality. Image credit: fizkes / Shutterstock


The COVID-19 pandemic has caused a massive influx of patients to physical and mental health facilities. Implementation of national and regional shutdowns early in the pandemic to limit the spread of severe acute respiratory coronavirus-2 (SARS-CoV-2) gradually led to adverse effects on public mental health due to increased social isolation. The absence of a social buffer effect due to the pandemic may exacerbate psychosocial problems with possible long-term physical and mental health consequences.

For example, loneliness, defined as the subjective state of feeling alone, is a public health problem in modern societies with increasing social isolation and anonymity. In contrast, social isolation is the objective state of lack of (social) relationships and being alone. According to some studies, social isolation and loneliness are significantly associated with mental and physical health indices such as depression, psychosocial stress, generalized anxiety disorder, a common obstructive pulmonary disease, cardiovascular disease, and mortality. In addition, studies have found an association between loneliness and neuroendocrine factors (cortisol levels).

The hypothesis of social buffering indicates that (social) relationships can improve both mental and physical health. Romantic relationships are intense and emotionally supportive interactions that meet intimate needs and attachments. Such interactions with a companion can relieve pain, stress, and psychological distress and affect immunity, the healing process, and mortality rates. In addition, single individuals have higher cortisol levels than couples, indicating that romantic relationships may reduce cortisol levels.

The study

The current study assessed the relationship status and life situation during the COVID-19 pandemic and lockdown as (potential) moderators of traits and state loneliness. The link between relationship status and trait loneliness was investigated. State loneliness and daily cortisol levels were assessed using the Ecological Instantaneous Assessment (EMA) approach. Relationship status and life situation are thought to affect state loneliness and cortisol levels.

Participants were eligible if they volunteered and were over 18 years old and fluent in German. The volunteers had to fill out online questionnaires. Loneliness scores were quantified using a German version of the 20-element loneliness scale from the University of California, Los Angeles (UCLA). Participants were asked to provide saliva samples to estimate cortisol levels at six different time points for two consecutive days – after awakening, 30 minutes, 45 minutes, 2.5 hours, 8 hours after awakening, and immediately before sleep. A short version of ‘partnerschaftsfragebogen (PFB) ‘was used to assess relationship quality.


About 1,483 people consented to participate, and 1,054 volunteers completed the online questionnaires. Participants had a mean loneliness score of 38.95, individuals in relationships and married people had the lowest loneliness score (average or M = 34.2). About 247 participants were included in the EMA study with saliva sampling. The average loneliness score for EMA students was 27.36. Couples living together had the lowest loneliness score of 21.42, while single people living alone had a higher score (M = 39.29).

Relationship status had a significant effect on mean cortisol levels. Mean cortisol levels were consistently higher in singles than in individuals living with a partner. Body mass index (BMI) was correlated with cortisol levels, while the life situation had no significant correlation. The relationship between relational status and momentary (state) loneliness had a significant effect, while the relationship between the state’s loneliness and life situation was insignificant. Individuals living alone had higher loneliness scores than those living with others (partners), and the interplay between relationship quality and life situation was negligible.


Current research assessed the association between structural and psychological factors with loneliness and cortisol levels during COVID-19 lockdown. Consistent with previous findings, the authors found that a loving relationship or living with a partner could be protective against loneliness and cortisol levels (neuroendocrine stress responses). Loneliness was highest among divorced or widowed than singles, indicating that the loss of partner or romantic support was associated with loneliness. Relationship quality did not moderate the association between loneliness and life situations.

The observations in the study highlight the protective effect of living together regardless of the quality of the relationship during the COVID-19 lockdown. Females reportedly reported higher levels of loneliness than men, adding to the growing evidence that women have a higher risk of loneliness.

In particular, current evaluations were performed without baseline parameters (controls), such as pre-COVID-19 lockdown analysis of cortisol levels and loneliness. Therefore, these results are only representative of the COVID-19 lockdown period.

*Important message

medRxiv publishes preliminary scientific reports that are not peer-reviewed and therefore should not be considered as crucial, guide clinical practice / health-related behavior or be treated as established information.

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