People With Schizophrenia May Have Higher COVID-19 Risk

Scientists have known that COVID-19 can be more serious for people with underlying conditions that already compromise their health. A new study from researchers at NYU Grossman School of Medicine adds another condition to that list: schizophrenia.

Published in the journal JAMA Psychiatry, the study suggested that people with schizophrenia have nearly a three times higher risk of death after contracting COVID-19. Kate Nemani, M.D., the study’s lead author and a professor at NYU Langone Health, said, “Our findings illustrate that people with schizophrenia are extremely vulnerable to the effects of COVID-19.”

The study examined the records of 7,348 adult patients treated at four hospitals and 260 outpatient centers in New York City. Of them, 75 had a diagnosis of schizophrenia spectrum disorders, 564 had a mood disorder and 360 had an anxiety disorder. Mortality rates were calculated based on death or discharge to hospice within 45 days following a positive COVID-19 diagnosis. Findings showed no increase in mortality rates for mood or anxiety disorders.

The study’s authors pointed out that previous studies in the U.S. have shown higher percentages of COVID-19 among people with psychiatric disorders. This is the first study to break out psychiatric diagnoses to examine them on a more individual basis. A study done in South Korea also reported a higher risk of severe complications and death from COVID-19 among people with psychotic disorders.

People with schizophrenia already have a lower life expectancy than those without, typically by about 15 years, according to The Lancet. It’s been thought that barriers to accessing health care, heart disease and depression were the cause. But this new study indicates that there may be something about schizophrenia itself that changes biology.

Nemani told MedPage Today there might be two reasons for the higher risk of mortality among people with schizophrenia: medications or immune system response. “Some studies have suggested a higher risk of mortality from respiratory illness associated with some antipsychotic medications,” she said. Alternately, people with schizophrenia may be have a lessened immune response to viruses. Nemani noted that a severe infection often precedes a diagnosis of schizophrenia.

“It remains to be seen whether this abnormal immune response could contribute to increased risk of death from infections, including COVID-19, and the psychiatric symptoms that they experience,” she said. The study noted that previous research has shown people with schizophrenia have less immunity at the cellular level. Nemani said her team will continue to conduct research to examine this.

Nemani hopes that the research will impact decision making regarding people with schizophrenia. “With this newfound understanding, health care providers can better prioritize vaccine distribution, testing and medical care for this group,” she said.