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We Need To Talk About the Potential Link Between COVID-19 and Schizophrenia

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I’ve spent the last three and a half years studying to complete my undergraduate education in neuroscience. In just a few months, I will graduate with my degree, and even though I am not planning to pursue neuroscience as a career anymore, the things I’ve learned will almost always be applicable to the things around me. Society as a whole has somewhat lost a proper appreciation for science, but the coronavirus (COVID-19) pandemic I believe is starting to highlight the need for science in most aspects of life. I don’t usually write articles on here focused on an academic subject, mainly to avoid going on a tangent of what I’ve learned in school. But a recent major discovery in the research surrounding the coronavirus and its connection to mental illness I believe deserves a spotlight in this community.

Late last month, a paper was published in the Journal of the American Medical Association Psychiatry (JAMA Psychiatry) that reviewed associations between severe mental illnesses and outcomes for coronavirus patients. The paper reviewed several thousand cases in the New York State Hospital System to determine if any significant links existed between psychiatric disorder diagnoses and how people with those disorders who also contracted the coronavirus recovered. The results, to say the least, were staggering. 

The results of the observational study show that a diagnosis of schizophrenia or schizophrenia spectrum disorders was associated with a higher mortality rate in patients with the diagnosis and a coronavirus diagnosis. Mood disorders and anxiety disorders were also analyzed in the study, but there were no significant links between those diagnoses and increased mortality rates. In fact, the authors of the study state that, besides increased age, schizophrenia or schizophrenia spectrum disorder diagnosis is the highest risk factor for mortality as a result of coronavirus infection.

Without going too far into the details of how the study was conducted, it was thorough in that it did consider other potential factors that would associate the two diagnoses and the increased mortality rate. To consider this in layman’s terms, what people have been hearing and seeing in popular media regarding the pandemic has largely focused on the major danger facing older patients. And it is true that increased age is the largest risk factor in patients ultimately die as a result of their infection. It was believed, prior to this study, that other factors would be leading contenders for the number two spot on the list of risk factors in mortality rates. Things such as other medical conditions, previous medical history, socioeconomic status and gender have all been thought to be linked to higher chances of dying as a result of coronavirus infection. While those things would make sense, especially current and previous medical conditions, are major risk factors for mortality, this study reflected that even when considering all of those things in patients with psychiatric disorders, schizophrenia and schizophrenia spectrum disorders were still the second-highest risk factor before age. So, what does this mean for research going forward in the mental illness world?

The paper was a statistical analysis, meaning essentially that no experiment was done. The researchers and their team analyzed data and reports from the New York State Hospital System and did a lot of complex math to see what the connection between psychiatric disorders and the coronavirus could be. This paper is only a week or two old since its publication, so the scientific community is still considering its methods, results and implications on the field. However, already major mental illness advocacy and research organizations have come out saying that the study appears incredibly legitimate. But what do these findings really mean in the short-term plans addressing the pandemic, and the long-term research efforts into treatments for psychotic disorders? 

For one, identifying increased mortality risk factors is incredibly important for health care providers in that they know which patients are more likely to require intensive therapies to avoid major complications, and ultimately succumbing to the illness. Now that it has been identified that a psychiatric disorder is the highest risk factor for death other than age, it has been suggested that efforts be undertaken to better evaluate the psychiatric medical history of patients entering hospitals and intensive care centers in a more systematic way.

When the pandemic was in its infancy, age and prior medical history of respiratory illnesses, like pneumonia and asthma, were considered as the most important factors to consider when treating patients. But that was when research was almost nonexistent into this virus. The world has lived for almost a year in quarantine and mask-wearing protocols, and the scientific community in almost every field has gathered together to concentrate efforts to identify how the pandemic could better be eradicated. No one initially would have considered psychiatric research as being significant to these efforts. But, more and more, it became clear that not only are there risks involved in comorbid diagnosis psychiatric disorders and the coronavirus but that the virus could cause long-term neurological damage, like abnormal movements and impaired cognitive abilities, such as memory loss. 

Questions remain about what the exact nature is between schizophrenia and the coronavirus. In essence, the scientific community is not yet sure why this risk factor exists in terms of the actual biology and physiology both illnesses. While the world may reach herd immunity before research can provide concrete answers to these questions, they do not pertain only to enhancing treatments for coronavirus patients, but in fact can have the opposite implication as well. Understanding how a virus like this seems to interact negatively with a psychiatric disorder will only further serve to enhance the scientific community’s understanding of psychotic disorders. In simpler terms, you can think of the coronavirus as another key to unlocking the door that hides the mystery of schizophrenia. 

Now, as I finish up this article that I hope I haven’t bored you, I want to make a couple of things clear. One, reflecting on and considering positive influences to scientific research as a result of the pandemic is not meant to downplay or sugarcoat the situation. No legitimate and qualified scientist will ever tell you that all of the deaths and long-term health issues that will exist for decades to come are somehow outweighed by the advances in many clinical fields of research. In fact, trying to pit the two against each other is not a good idea to begin with. No one wanted this pandemic to happen, and no one wanted anyone to die from it. But if the pandemic produced nothing but negative and destructive effects on society and knowledge, it would truly be more morally devastating to humanity.

The effects of this pandemic will be felt likely by every generation that has lived during it, and in many respects may permanently shape the medical landscape of the world. But those effects also include the mass amount of research that the virus has opened the door to in just about every realm of medicine. It is already being explored whether the treatments developed over the last year could have positive benefits for people who experience chronic asthma or other respiratory illnesses. The aforementioned neurological complications may shine a light on many cognitive and physical disorders most people probably wouldn’t have associated with the coronavirus. And now, it appears there is hope for the virus to help unlock the major questions that lie in the realm of major mental illnesses like schizophrenia.

We who live every day with mental and/or physical illnesses and disabilities understand the practical elements to health challenges. The scientific community understands those same illnesses and disabilities from the opposite side of the coin, what the causes and potential treatments are based on the biology, chemistry and physiology of those conditions. As someone who likes to identify as existing in both worlds, I don’t understand why there aren’t more efforts to make research more accessible to the wider public, especially those affected by the conditions of interest.

I also think there needs to be a serious conversation about how people with medical conditions and disabilities are viewed in the eyes of research. We are not lab rats. Advertisements for joining scientific studies are important, but there needs to be a common understanding that the subjects of research are people and not just their conditions. And that common understanding needs to be felt by both researcher and subject.

 There is a lot of work to do ahead of us, and so long as medical challenges exist, there will be work to do in the scientific community. But this paper is a glimmer of hope to the millions of people who live with psychotic disorders like schizophrenia. It also will hopefully improve outcomes for those same people who happen to become infected with the coronavirus.

You can read the research for yourself here.

Photo by Mayan Sachan on Unsplash

Originally published: February 9, 2021
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