Several months into the COVID-19 pandemic data suggested that individuals with schizophrenia spectrum disorders are more likely to die from illnesses related to COVID-19 than those without schizophrenia. More than a year later, why this population appears to be at increased risk of death from COVID-19 continues to remain unclear. A research letter appearing today in JAMA Psychiatry found no association between antipsychotic use and mortality in adults with a serious mental illness (SMI) who were diagnosed with COVID-19.
“An association between antipsychotic medication and increased risk of COVID-19 mortality has been reported in population-based studies, but these studies did not take psychiatric diagnosis into account,” wrote Katlyn Nemani, M.D., of the New York University (NYU) Langone Medical Center and colleagues.
To examine the relationship between antipsychotic use and COVID-19 outcomes in patients with SMI, the researchers used data contained in the NYU Langone Health electronic health record system. The researchers included in their analysis adults who were diagnosed with COVID-19 infection between March 3, 2020, and February 17, 2021, and who had a preexisting diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder.
A total of 464 patients (mean age, 53 years) were included, of which 196 (42.2%) were treated with antipsychotic medication. Forty-one patients (8.8%) died within 60 days of being diagnosed with COVID-19. “The 60-day case fatality rate among patients with a schizophrenia spectrum disorder (n = 182) was 13.7%, and the case fatality rate among patients with bipolar disorder (n = 282) was 5.7%,” Nemani and colleagues noted.
After controlling for age, body mass index, insurance type, and psychiatric diagnosis, the researchers found that antipsychotic treatment was not significantly associated with mortality. However, patients who had a preexisting diagnosis of schizophrenia spectrum disorder were nearly three times as likely to die from COVID-19 than those with a preexisting diagnosis of bipolar disorder.
“Further research is needed to understand what underlies increased mortality risk in this population to address worsening health disparities,” Nemani and colleagues concluded.
For related information, see the Psychiatric News article “COVID-19 Greatly Increases Mortality Risk for Schizophrenia Patients, Research Shows.”
(Image: iStock/gorodenkoff)
Clozapine REMS Requirements Will Change November 15
The FDA recently approved modifications to the Clozapine Risk Evaluation and Mitigation Strategy (REMS). All prescribers and pharmacies must be re-certified by Monday, November 15, to be able continue prescribing/dispensing clozapine. SMI Adviser will host a webinar on how to navigate this process on Wednesday, September 29, at 3 p.m. ET.
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