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Previous studies have found that people with mental illness, especially those suffering from depression and schizophrenia, an illness that distorts thinking and perception, are at an increased risk of being infected with the SARS-CoV-2 virus, which causes COVID-19. . However, until now it has not been known whether mental illness is associated with an increased risk of dying from COVID-19, writes livescience.com.
In a new study, researchers analyzed medical records from 260 outpatient clinics and four New York City hospitals. They used data published by the New York University electronic health system. Of the 26,540 patients studied (approximately 4,500 individuals were not evaluated for various reasons), coronavirus was detected in 7,348 patients between March 3 and May 31.
Mentally ill patients were divided into three groups: schizophrenia spectrum patients, mood disorders, and anxiety disorders. They were compared to COVID-19 patients who did not have any mental illness. The results were then adjusted for known COVID-19 risk factors: high blood pressure, diabetes, heart disease, chronic obstructive pulmonary disease, chronic kidney disease, smoking, and cancer.
Of more than 7 thousand. Of the patients diagnosed with coronavirus at the time, 75 had schizophrenia, 564 had mood disorders, and 360 had anxiety disorders. Altogether, 864 COVID-19 patients died in 45 days or were transferred to a nursing home.
The researchers found no association between anxiety or mood disorders and death from COVID-19. However, they found that people with schizophrenia were 2.7 times more likely to die from COVID-19 than people without the disease. This means that schizophrenia is the second highest risk factor after human age.
By comparison, patients aged 45 to 54 die 3.9 times more often from COVID-19 than younger people (people over 54 this risk doubles every ten years) and patients with heart failure or diabetes die from COVID-19, respectively 1. 65 and 1.28 times more often.
Believed but still surprised
But why is this mental illness associated with the risk of dying from COVID-19?
“It was believed, but it’s still surprising,” said Donald Goff, lead author and professor of psychiatry at New York University School of Medicine. Studies have shown that people with schizophrenia have a shorter life expectancy by an average of 20 years – many of them die prematurely from pneumonia and viral illnesses, he said.
However, this shorter life expectancy has so far been primarily associated with other medical risk factors that often accompany schizophrenia, such as obesity, heart disease, and smoking. Therefore, in this study, people with schizophrenia still had an increased risk of mortality, although the authors considered these conditions.
“It seemed to be related to schizophrenia itself or, perhaps, drugs that increase your risk of mortality,” Goff told Live Science. For example, perhaps a disease or medication disrupts the immune system, he considered. An earlier study found that people with schizophrenia have altered immune responses and genetic variations that regulate the body’s immune response to infections.
“This is a very interesting study, especially given the role of the immune system,” said Norbert Muller, a professor of psychiatry at the Ludwig Maximilian University in Munich who was not involved in the study. Some psychiatrists speculate that schizophrenia is related to the activation of the immune system and molecules that signal inflammation called cytokines, he said. A common cause of death from COVID-19 is precisely an exaggerated cytokine response, also called a cytokine storm.
“Such a mechanism could also work in schizophrenia. It could be a normal course of schizophrenia and a road to death with COVID-19,” Muller told Live Science. But the genes that instruct and regulate the immune response may also be involved. However, this study is limited due to the small number of patients with schizophrenia and the lack of information on the medications used by these patients (the authors themselves point this out), he added.
Additionally, this study only used data from patients treated in the New York University health care system, and was collected during the outbreak in New York itself, when testing was done primarily on high-risk and symptomatic individuals.
“Back then, the rates were so high, and the whole system was about to fail, and the treatment was not as effective as it is now,” Goff noted. Since then, “absolute death rates have decreased, but we believe it may still be true that people with schizophrenia are at higher risk.”
Goff and his team are conducting further research to see if there are biological reasons why patients with schizophrenia may be at increased risk of dying from COVID-19. But for now, “we think it’s important to get people’s attention,” Goff said. People diagnosed with schizophrenia should also have a preference for the COVID-19 vaccine, he added.
The results of this study were published in the journal JAMA Psychiatry on January 27.
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