Covid-19 Patients With Schizophrenia Might Be At A Higher Risk Of Death – Forbes

NEW YORK, NEW YORK - JANUARY 27: People walk by a sign for both a Covid-19 testing outside of a ... [+] Brooklyn hospital on January 27, 2021 in New York City. With the overall infection rate across the state on the decline and 72% of healthcare workers now having received the COVID-19 vaccine, Governor Andrew Cuomo has announced that some restrictions in New York may be lifted in the near future. According to the Governor this will not include indoor dining. (Photo by Spencer Platt/Getty Images)

A schizophrenia spectrum diagnosis could be at a higher risk of severe Covid-19 and might also face a 2.7 times higher risk for mortality within 45 days of testing positive, according to the results of a study published in JAMA Psychiatry.

This association may be attributable to socioeconomic and environmental factors that contribute to exposure such as crowded housing, institutional settings, and lack of personal protective equipment, Dr. Katlyn Nemani, of the department of psychiatry at New York University Langone Medical Center and two other colleagues wrote. Because outcomes may differ by diagnosis, it is important to determine which infected patients are at increased risk of adverse outcomes.

The researchers further found that even after taking into account or adjusting for other risk factors such as smoking, hypertension, heart failure, diabetes, chronic kidney disease, myocardial infarction, and cancer, the association of schizophrenia with a higher risk of mortality was still significant.

Schizophrenia spectrum disorder includes paranoid schizophrenia, catatonic schizophrenia, hebephrenic or disorganized schizophrenia, residual schizophrenia, and undifferentiated schizophrenia.

People living with this disorder experience hallucinations, delusions, disorganized speech, paranoia, depression, impaired motor coordination, and disorientation, among other psychotic symptoms.

According to the National Institute of Mental Health, the prevalence of schizophrenia and related psychotic disorders in the U.S. range between 0.25% and 0.64%.

In this study, the researchers analyzed data of 7,348 adults for 45 days after they were diagnosed with Covid-19 between March 3, 2020, and May 31, 2020, in a medical system in New York. Individuals who did not have medical records before testing were excluded.

Then, the researchers extracted psychiatric diagnostic codes and medical co-morbidities from their electronic health records using billing and external claim diagnoses along with in-patient hospital problems before their testing encounter.

From that, 75% of patients had a history of schizophrenia spectrum illness. Another 7.7% had a history of a mood disorder and 4.9% were diagnosed with an anxiety disorder.

Overall, 864 patients (11.8%) died or were discharged to hospice within 45 days of a positive coronavirus test result. A schizophrenia spectrum diagnosis was significantly associated with 45-day mortality.

Beyond systemic barriers to care and delayed treatment, adults with schizophrenia spectrum diagnoses may be more susceptible to COVID-19 mortality due to biological factors related to their psychiatric illness or treatment, the researchers wrote.

They further observed that the results of their analysis were consistent with those of a nationwide study from South Korea in which government-mandated testing and enhanced monitoring were provided to all citizens.

The South Korean investigators reported a similar risk of infection but a higher risk of severe clinical outcomes in patients with psychotic disorders.

Although the mechanism underlying this association is not clear, immune dysregulation in the setting of genetic or acquired risk factors is a possibility, added the researchers.

Despite the studys comprehensive data that included a large number of patients who test positive for the coronavirus, the study has its own limitations. First, the accuracy of clinical psychiatric diagnoses could not be validated in all patients. Also, patients with psychiatric disorders like schizophrenia might be less likely to seek professional help because of stigma, isolation, and systemic barriers to mental health care.

Lastly, the researchers note that these findings could not be used as a generalization for other patients as the study took place n a severely challenged health system during a peak of the COVID-19 pandemic.

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Covid-19 Patients With Schizophrenia Might Be At A Higher Risk Of Death - Forbes