Studies have already found that adults with serious mental illness (SMI) have an increased risk of COVID-19 infection and COVID-19–related mortality. Now a study issued yesterday in JAMA Network Open reports that adults with SMI are also significantly more likely to develop long COVID.
Long COVID, or post-acute sequelae of SARS-CoV-2 infection (PASC), refers to new symptoms that present four weeks or later after the initial infection, such as dyspnea (shortness of breath), fatigue, cognitive dysfunction, anxiety, and coagulation disorder.
Veer Vekaria, B.S., of Weill Cornell Medicine in New York, and colleagues used health records data from the National Patient-Centered Clinical Research Network to compare outcomes over six months for 1.6 million U.S. adults with a confirmed COVID-19 infection between March 2020 and October 2022 who also attended a follow-up visit 30 or more days postinfection. Among the sample, 16% had SMI, defined by researchers as bipolar disorder, schizophrenia, or recurrent major depressive disorder.
Overall, most patients had low COVID severity and were not hospitalized (90%); however, one-quarter developed PASC. Among patients with PASC, the most common subtypes were neurological (33%), respiratory (27%), circulatory (19%), or endocrine (19%) related.
Among patients with a prior SMI, 28% developed PASC. After adjusting for demographics, people with any SMI were 10% more likely to develop PASC. The increased risk held true for each individual SMI category; COVID patients with schizophrenia, bipolar disorder, or recurrent depression were 7%, 14%, and 8% more likely to develop PASC, respectively.
“The consistency of these findings in each of the SMI categories—schizophrenia, bipolar disorder, and recurrent MDD—suggests transdiagnostic vulnerabilities to long-term adverse effects of COVID-19 among adults with severe mental illnesses,” the researchers wrote. “… Chronic stress and immune dysregulation associated with an SMI can exacerbate the risk of PASC, making these individuals more prone to persistent symptoms due to underlying physical and mental health vulnerabilities.”
For related information, see the Psychiatric News article “Psychiatrists Uniquely Suited for Helping Patients With Long-Haul COVID-19.”
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