COVID-19 infection, hospitalisation and mortality rates in people with severe mental illness: findings from two UK cohort studies

Introduction: Recent systematic reviews have highlighted that people with Severe Mental Illness (SMI) have higher risks of infection, hospitalisation and death from COVID-19, although the full extent of these disparities are not yet established. Objective(s): Utilising electronic health records, we investigated COVID-19 related infection, hospitalisation and mortality among people with schizophrenia/psychosis, bipolar disorder (BD) and/or major depressive disorder (MDD) in two large UK samples: the UK Biobank (UKB) cohort study and GP-registered patients in Greater Manchester (GM). Method(s): We sampled 447,296 adults with and without SMI from UKB (inc. schizophrenia/psychosis=1,925, BD=1,483 and MDD =41,448, non-SMI=402,440) and 1,152,831 adults from GM (inc. schizophrenia/psychosis =46,859, BD=3,461, recurrent MDD= 134,661, non-SMI = 922,264). Primary care, hospital and death records were linked to identify COVID-19 related outcomes. Logistic regression models were used to estimate unadjusted and adjusted Odds Ratios (ORs) to compare differences in COVID-19 outcomes by diagnosis, controlling for sociodemographic factors and comorbidities. Result(s): We will report the findings of unadjusted and adjusted analyses, comparing ORs for people with and without SMI, by diagnosis. Findings will be compared between the two datasets, with attention to the demographic and clinical profiles of each sample. We will consider the role of demographic characteristics and comorbidities in attenuating outcomes. Conclusion(s): Emerging evidence suggests that people with SMI have higher risks of COVID-19 infection, hospitalisation and mortality. Based on two large datasets utilising EHRs, we present findings from the UK on COVID-19 outcomes among people with SMI, a country that has been severely affected by COVID-19.

PEPFAR's response to the convergence of the HIV and COVID-19 pandemics in Sub-Saharan Africa

The COVID-19 pandemic reached the African continent in less than three months from when the first caseswere reported from mainland China. As COVID-19 preparedness and response plans were rapidly instituted across sub-Saharan Africa, many governments and donor organizations braced themselves for the unknown impact the COVID-19 pandemicwould have in under-resourced settings with high burdens of PLHIV. The potential negative impact of COVID-19 inthese countries is uncertain, but is estimated to contribute both directly and indirectly to the morbidity and mortality ofPLHIV, requiring countries to leverage existing HIV care systems to propel COVID-19 responses, while safeguarding PLHIVand HIV programme gains. In anticipation of COVID-19-related disruptions, PEPFAR promptly established guidance to rapidlyadapt HIV programmes to maintain essential HIV services while protecting recipients of care and staff from COVID-19. Thiscommentary reviews PEPFARs COVID-19 technical guidance and provides country-specific examples of programme adaptionsin sub-Saharan Africa.