The researchers of the University of California San Francisco (UCSF) and the San Francisco Veterans Affairs Health Care System, they found that patients older than 65 years with substance abuse, psychotic disorders, bipolar disorder, adjustment disorder and anxiety, faced an increased risk, up to 24%, of progression of COVID-19. For those under 65the risks were up to 11% higher than for those without a psychiatric history. this finding it may be related to a response from an impaired immune system.
For both groups, Data was adjusted for age, sex, race, ethnicity, and vaccine type, as well as smoking and underlying conditions such as obesity, diabetes, sleep apnea, cardiovascular, lung, kidney, and liver disease, HIV, and cancer. In the study, which was published in JAMA Network Open, The researchers tracked data on more than 250,000 patients from the US Department of Veterans Affairs, who had completed their vaccination regimen and had at least one test for SARS-CoV-2.
A little more than half (51.4%) of the patients had received at least one psychiatric diagnosis in the last five years and 14.8% developed a COVID outbreak, confirmed by a positive test. Decreased immunity and less protection from new variants may explain the higher rates.
“Our research suggests that the increase in breakthrough infections in people with psychiatric disorders cannot be fully explained by sociodemographic factors or pre-existing conditions,” explained lead author Aoife O’Donovan, of the UCSF Weill Institute for Neurosciences, System of Care Veterans Physician and the University of San Francisco. It is possible that immunity after vaccination declines more rapidly or more strongly in people with psychiatric disorders and/or they may have less protection against newer variants.”
A study earlier this yearled by the same UCSF researchers, found that people with high anxiety and probable post-traumatic stress disorder, conditions associated with impulsivity, They had more likely to engage in behaviors that put them at higher risk for COVID.
The average age of 263,697 participants were 66 years old and 90.8% were men. Overall, participants with psychiatric disorders had a 3% increased risk of COVID infections in 2021, when adjusted for demographic factors and pre-existing conditions, compared to participants without a psychiatric history. But the risk was 24% higher for those over 65 with substance abuse, 23% higher for those with psychotic disorders, 16% higher for bipolar disorder, 14% for adjustment disorder, and a 12% for anxiety. Surprisingly, given the higher incidence of breakthrough infections among younger people, this study showed significantly reduced effects in the group younger than 65 years.
In addition, the risks were 10% lower in participants with psychotic disorders compared to those without a psychiatric diagnosis, a decrease that O’Donovan attributes to possible lower socialization among younger people with psychotic disorders compared to those without a psychiatric diagnosis. with older people who “may be less socially isolated because of their greater burden of poor health and contacts with caregivers,” he said. However, the risks of intercurrent infections associated with substance abuse, adjustment disorder, anxiety, and post-traumatic stress disorder were higher in the younger cohort than in their peers without a psychiatric diagnosis: 11%, 9%, 4% and 3%, respectively.
the first author, Kristen Nishimi, PhD, also of the UCSF Weill Institute for Neurosciences and the San Francisco Veterans Health Care System, believes that the higher incidence of breakthrough infections among older participants may be due to “a lower immune response to the vaccine that has been associated with some psychiatric disorders, which may be more prominent in older adults.” It’s also possible that older adults with psychiatric disorders “may require more frequent in-person care, which could increase their interactions with the health care system,” he added.
Risks for other non-psychiatric conditions were also calculated and adjusted for factors such as obesity and smoking, as well as other underlying ailments. The researchers found that patients with chronic kidney disease had a 23% increased risk, compared with 20% for HIV, 19% for cardiovascular disease, 18% for COPD and 13% for sleep apnea. This shows that certain psychiatric conditions, particularly in the 65+ age group, face risks that are on par with other conditions —O’Donovan pointed out. Mental health is important to consider alongside other risk factors and some patients should be prioritized for booster shots and other critical preventative issues.”