Schizophrenia is associated with risk factors for poor outcomes with SARS-CoV-2/coronavirus disease 2019 (COVID-19) infection, including diabetes, hypertension, and chronic obstructive pulmonary disease (COPD). A recent study found that schizophrenia was associated with an increased risk of severe COVID-19 infection. Whether health outcomes and care differ between patients with COVID-19 with (versus without) comorbid schizophrenia remains unclear. Fond and colleagues2 compared in-hospital mortality and intensive care unit (ICU) admissions between patients with schizophrenia and those without a diagnosis of severe mental illness in a French population-based cohort study.
People with severe mental illness (SMI) are a vulnerable population. In the context of COVID-19, there is reason to suspect they may be at increased risk of contracting SARS-CoV-2 and have worse outcomes following infection, however we found no existing data that quantified these risks. Public health measures associated with COVID-19, including quarantine of suspected cases and lockdowns may negatively affect the mental health status of people with SMI, through change of environment, disruption of services, increased stress and isolation. Existing research points to greater psychological distress during the pandemic for people with SMI, rather than demonstrating this distress is due to the pandemic. The authors concluded that this is the largest series of patients with schizophrenia and COVID-19 to date. They found evidence for the existence of disparities in health and health care between patients with versus without schizophrenia, including increased in-hospital mortality and decreased ICU admission. Study limitations include the absence of data on the time between onset of infection and hospitalization, psychotropic medication, and the use of anti-COVID-19 treatments. Nevertheless, findings suggest the importance of health care strategies before, during, and after hospitalization for reducing health disparities in this vulnerable population
Normally, younger patients with schizophrenia who smoke, are obese, and have COPD are at heightened risk for poor outcomes with COVID-19 infection and should be targeted for early intervention.
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