RESEARCH WEEKLY: More Evidence that People with Severe Mental Illness are at Higher Risk of Mortality from COVID-19
By Kelli South
The evidence continues to mount showing that people with severe mental illness are at higher risk of dying from COVID-19. The study, released in JAMA Psychiatry last week, includes data from seven different countries including the United States and confirms that people with mental health diagnoses are a high-risk group as we continue to fight the COVID-19 pandemic.
Study details
The study is a systematic review and meta-analysis of existing studies on COVID-19 and mental health disorders published between the start of the pandemic and the winter of 2021. The review included 16 studies from seven different countries: Denmark, France, Israel, South Korea, Spain, the United Kingdom and the United States. There were 19,086 COVID-19 patients with mental health disorders − including schizophrenia, bipolar disorder, major depressive disorder, anxiety disorders, personality disorders, eating disorders and substance use disorders − analyzed from the combined 16 studies. All the studies included in the report were assessed for quality before being included in the analysis.
Results
The results of the meta-analysis revealed an increase in likelihood of death from COVID-19 for those with a mental health disorder compared to those without. When only looking at studies that included patients with severe mental illness, the odds of dying from COVID-19 were 1.67 times greater than for those without a severe mental illness.
Patients with schizophrenia and bipolar disorder were found to be at the highest risk of death from COVID-19. The authors are unable to say for certain why mental illnesses, and particularly severe mental illnesses, put people at greater risk for COVID-19 mortality. They point to a variety of factors that should be investigated, including barriers to accessing healthcare, immunological differences and social factors like socioeconomic status, in addition to the comorbidities that often come with severe mental illness like obesity and smoking.
Implications
The analysis also found an increased risk of death from COVID-19 for people who misused alcohol and other drugs. As the Treatment Advocacy Center wrote in an evidence brief earlier this year, people with serious mental illness are also more likely to have a co-occurring substance use disorder. The existence of a co-occurring substance use disorder can compound many of the issues faced by people with serious mental illness, exacerbating symptoms and causing a variety of societal and treatment barriers for the population. The same is likely true in the COVID-19 pandemic: those with co-occurring disorders could be at an even higher risk of death from COVID-19 given this study’s results. The risks associated with COVID-19 and co-occurring substance use disorder and serious mental illness should be a subject for future research.
This study adds to the reasons why people with mental illnesses, particularly those with severe mental illnesses, should be included as a high-risk population for COVID-19, prioritized for the COVID-19 vaccine, and specifically targeted with outreach efforts to get the vaccine and prevent the contraction of COVID-19 in the first place. This population faces greater risks when it comes to the pandemic and policymakers must be aware of this when shaping a country, state or locality’s COVID-19 public policies.
References
