Persons with schizophrenia and severe mood and anxiety disorders are less likely to get Covid-19; however, they are at a higher risk of dying, once they develop the infection, suggests a new study published in JAMA Network Open.

The cross-sectional study reviewed electronic health records of 2.5 million adults across the United States, who were tested for Covid-19 in 2020. Their mean age was 44 years. Data was sourced from the Optum COVID-19 Electronic Health Record (EHR) database. Patients with schizophrenia (n=3350), mood disorders (n=26,610) or anxiety disorders (n=18,550) were categorized into three study groups, while the remaining participants with no major psychiatric disorder formed the control group. Data was analyzed from March to April 2021.

Results showed that patients with schizophrenia or mood disorders had a lower positivity rate than those with anxiety disorder; 9.86% vs 11.17%, respectively. The positivity rate in the control group was 11.91%. Despite lower positivity rates, schizophrenia patients were found to be almost 4 times more at risk of Covid-related death (OR 3.74). Those with mood disorders were at a three-fold higher risk of death from Covid (OR 2.76), while the odds of dying were increased two-folds in patients with anxiety disorders (OR 2.39).

This study has shown that patients with major psychiatric disorders such as schizophrenia and mood/anxiety disorders have lower SARS-CoV-2 infection rates, but the mortality rate due to Covid-19 is higher, which is independent of the different comorbid conditions present in these patients. These patients are more socially withdrawn and the authors hypothesize that this could be a reason for the lower infection rate. Or, it may be due to lower testing rates. Schizophrenia is a low inflammatory condition in itself; the hyperinflammatory response in Covid-19 may augment the underlying inflammation leading to increased mortality.

Reference

1. Teixeira AL, et al. Analysis of COVID-19 infection and mortality among patients with psychiatric disorders, 2020. JAMA Netw Open. 2021 Nov 1;4(11):e2134969. doi: 10.1001/jamanetworkopen.2021.34969.