People with schizophrenia had higher odds of dying from COVID-19 but, along with people with mood disorders, had significantly lower rates of testing positive for COVID-19 compared with the general population. Researchers published their findings in JAMA Network Open.

“After fully adjusting for demographic factors and comorbid conditions,” researchers reported, “patients with schizophrenia were nearly 4 times more likely to die from the disease than the reference group (OR, 3.74; 95% CI, 2.66-5.24).”

Using electronic health record data for 2.5 million US patients in 2020, researchers compared patients with 3 types of psychiatric disorders (schizophrenia, mood disorders, and anxiety disorders) and a reference group of patients with no major psychiatric conditions on 2 measures: the odds of testing positive for COVID-19 and the odds of death from COVID-19.

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Results showed COVID-19 positivity rates of 9.86% for the schizophrenia cohort and 9.86% for the mood disorder cohort, which were significantly lower than positivity rates for the anxiety disorder cohort (11.17%) as well as the general population (11.91%).

In addition to finding patients with schizophrenia who had COVID-19 were nearly 4 times more likely to die from it compared with the reference group, the study found that patients with mood disorders had 2.76 times greater odds of COVID-19 mortality, while the anxiety disorder cohort had a 2.39 times greater odds of mortality, compared with the reference group.

Researchers believe lower rates of COVID-19 positivity in people with schizophrenia and mood disorders could reflect either less virus exposure due to social withdrawal or, alternatively, lower testing numbers rather than reduced infection rates.

“Upon review of the site of COVID-19 testing, it was revealed that the patients with schizophrenia had a much higher rate (almost 40%) of receiving a test at an inpatient facility, including a psychiatric facility,” researchers wrote. “These patients would ostensibly be less likely to seek testing in outpatient clinics or dedicated sites, probably undergoing COVID-19 tests when presenting related symptoms.”

Reference

Teixeira AL, Krause TM, Ghosh L, et al. Analysis of COVID-19 infection and mortality among patients with psychiatric disorders, 2020. JAMA Netw Open. Published online November 1, 2021. doi: 10.1001/jamanetworkopen.2021.34969