People with certain mental illnesses have higher COVID risk — here's why

Before COVID-19 booster shots were authorized for all adults, the U.S. government had already recommended boosters for Americans with certain high-risk conditions, including mental health conditions. The decision came after numerous studies linked mental health disorders to a higher COVID-19 risk and more severe outcomes, NPR reported Nov. 22.

One study, conducted at Yale New Haven (Conn.) Health System, included data from 1,685 COVID-19 patients hospitalized between Feb. 15 and April 25, 2020, along with a May 27, 2020, follow-up. The data didn't include treatment information.

Of the 1,685 patients, 473 (28 percent) had received psychiatric diagnoses before the admission. Patients with psychiatric diagnoses were more likely to be older, female, white and have medical comorbidities (malignant cancer, cerebrovascular disease, congestive heart failure, diabetes, kidney disease, liver disease, myocardial infarction and/or HIV). Overall, 318 patients (18.9 percent) died. 

Researchers found that patients with a psychiatric diagnosis had a higher COVID-19 mortality rate compared to those with no psychiatric diagnosis, even after controlling for demographic characteristics, other medical comorbidities and hospital location. The risk of death from COVID-19 went up 50 percent for those with a history of mental illness, said Luming Li, MD, a psychiatrist who had been working at Yale University at the time and is now CMO at the Harris Center for Mental Health and IDD in Houston.

Another study published in October 2020 examined a national EHR database and found individuals with any history of a mental disorder were more likely to get COVID-19, Nora Volkow, MD, study author and director of the National Institute on Drug Abuse, told NPR. 

"And if they got infected, then they were more likely to have negative outcomes, such as hospitalization and death," she said.

There are many reasons psychiatric illness may be tied to an increased COVID-19 mortality risk. Mental illnesses may change people's behaviors to make them less likely to protect themselves from an infection using measures like social distancing or mask-wearing. Individuals with mental illness also tend to have poorer overall health and chronic health issues. Additionally, many medications used to treat mental illnesses, particularly antipsychotics, can increase the risk of chronic health problems, Dr. Volkow told NPR.

The risk is higher for people with serious mental illness, but it must be remembered that mental illness is not static; it is constantly changing.


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