Open Access

Daniel Deimel, Thorsten Köhler, Janina Dyba, Niels Graf, Christine Firk

• Background The ongoing Covid-19 pandemic not only threatens physical health, but also affects the mental health of people. Yet, health consequences of the pandemic do not affect all members of society equally. We therefore assessed the mental health burden of individuals who are at increased risk of severe illness from Covid-19 compared to individuals who are at low risk of severe illness during the first lockdown (March, 2020) in Germany. Furthermore, we investigated variables mediating the effect of being an individual at increased risk of serve illness on depression. Methods Adult German residents (n = 2.369) provided responses to a cross-sectional online survey about risk factors for of severe illness from Covid-19 and various aspects of mental health during the first lockdown in Germany. For data collection, standardized and validated self-report measures were used and for data analysis Mann-Whitney U-tests as well as regression and mediation analyses were performed. Results The results clearly show that the mental health burden is higher among individuals at increased risk of severe illness from Covid-19 compared to individuals at low risk of severe illness from Covid-19. Moreover, our findings indicate that the association between Covid-19 risk status and depressive symptoms is mediated by concerns about mental health, anxiety and loneliness in a causal effect chain. Conclusions Individuals at increased risk of severe illness from Covid-19 have an increased need for psychosocial support during times of lockdown. Future public health policies should pay special attention to these individuals and support them by targeted offers. More research, however, is needed on possible long-term consequences of social distancing on mental health.