Wednesday, January 27, 2021

Patients With Schizophrenia Have More Than Twice the Risk of Death Related to COVID-19

Individuals with schizophrenia spectrum disorders appear to have more than twice the risk of dying from illness related to COVID-19 than do those without schizophrenia, according to a study published today in JAMA Psychiatry. The study further found that people with mood and anxiety disorders were not at a greater risk of mortality from COVID-19 compared with people without these disorders.

“The results of this analysis suggest that the risk of severe or fatal illness may differ by diagnosis,” wrote Katlyn Nemani, M.D., of New York University Langone Medical Center and colleagues. “In a population that may be more susceptible to infection, determining which patients may be at highest risk for adverse outcomes is necessary to guide clinical decision making, including the need for enhanced monitoring and targeted interventions.”

Nemani and colleagues analyzed data from the electronic health records of 7,348 adults, aged 18 years or older, who tested positive for coronavirus 2 (SARS-CoV-2) between March 3 and May 31, 2020, in the NYU Langone Health System. The system includes more than 260 outpatient office sites and four acute care hospitals in Manhattan, Brooklyn, and Long Island, N.Y.

The authors classified these patients into one of three groups: those with schizophrenia spectrum disorders (n=75), mood disorders (n=564), and anxiety disorders (n=360). Patients in each category were compared with 6,349 patients who did not have psychiatric diagnoses documented before March 3, 2020.

Overall, 864 patients (11.8%) died or were discharged to hospice within 45 days of a positive test result. The researchers found that after adjusting for demographic factors (age, sex, and race), patients with schizophrenia spectrum disorders were 2.87 times more likely to die from COVID-19 within 45 days of testing positive than individuals with no mental illness; after adjusting for medical risk factors, patients with schizophrenia spectrum disorders were 2.67 times more likely to die from COVID-19 within 45 days of testing positive than individuals with no mental illness. After adjusting for similar factors, the researchers found that patients with mood disorders and anxiety disorders were not more likely to die from COVID-19 compared with individuals with no mental illness.

“The most notable finding from this study is the high risk of mortality associated with schizophrenia spectrum diagnoses, ranking second behind age in strength of an association among all demographic and medical risk factors examined in this sample,” Nemani and colleagues wrote. “Targeted interventions may be needed for patients with severe mental illness to prevent worsening health disparities.”

For more information, see the Psychiatric News article “COVID-19 and People With SMI—New Notes From the Field.”

(Image: iStock/SDI Productions)

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