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Factors associated with COVID-19 Infection among a national population of individuals with schizophrenia or schizoaffective disorder in the United States.
Liberman, Joshua N; Pesa, Jacqueline; Petrillo, Mary Pat; Ruetsch, Charles.
  • Liberman JN; Health Analytics, LLC, Columbia, MD, USA. j.liberman@healthanalytics.com.
  • Pesa J; Janssen Scientific Affairs, Titusville, NJ, USA.
  • Petrillo MP; Janssen Scientific Affairs, Titusville, NJ, USA.
  • Ruetsch C; Health Analytics, LLC, Columbia, MD, USA.
BMC Psychiatry ; 22(1): 376, 2022 06 02.
Article in English | MEDLINE | ID: covidwho-1875003
ABSTRACT

BACKGROUND:

Individuals with schizophrenia are a vulnerable and under-served population who are also at risk for severe morbidity and mortality following COVID-19 infection. Our research was designed to identify factors that put individuals with schizophrenia at increased risk of COVID-19 infection.

METHODS:

This study was a retrospective cohort analysis of medical and pharmacy claims among 493,796 individuals residing in the United States with schizophrenia or schizoaffective disorder, between January 1, 2019 and June 30, 2020. A confirmed diagnosis of COVID-19 infection by September 30, 2020 was regressed on demographics, social determinants, comorbidity, and pre-pandemic (December 2019 - February 2020) healthcare utilization characteristics.

RESULTS:

A total of 35,249 (7.1%) individuals were diagnosed with COVID-19. Elevated odds of COVID-19 infection were associated with age, increasing consistently from 40-49 years (OR 1.16) to 80+ years (OR5.92), male sex (OR 1.08), Medicaid (OR 2.17) or Medicare (OR 1.23) insurance, African American race (OR 1.42), Hispanic ethnicity (OR 1.23), and higher Charlson Comorbidity Index. Select psychiatric comorbidities (depressive disorder, adjustment disorder, bipolar disorder, anxiety, and sleep-wake disorder) were associated with elevated odds of infection, while alcohol use disorder and PTSD were associated with lower odds. A pre-pandemic psychiatry (OR0.56) or community mental health center (OR0.55) visit were associated with lower odds as was antipsychotic treatment with long-acting injectable antipsychotic (OR 0.72) and oral antipsychotic (OR 0.62).

CONCLUSIONS:

Among individuals with schizophrenia, risk of COVID-19 infection was substantially higher among those with fewer economic resources, with greater medical and psychiatric comorbidity burden, and those who resided in African American or Hispanic communities. In contrast, individuals actively engaged in psychiatric treatment had substantially lower likelihood of infection. These results provide insights for healthcare providers that can translate into improved identification of at-risk individuals and interventions to reduce the risk and consequences of COVID-19 infection.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Psychotic Disorders / Schizophrenia / Antipsychotic Agents / COVID-19 Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study / Qualitative research Topics: Long Covid Limits: Adult / Aged / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: BMC Psychiatry Journal subject: Psychiatry Year: 2022 Document Type: Article Affiliation country: S12888-022-04026-7

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Psychotic Disorders / Schizophrenia / Antipsychotic Agents / COVID-19 Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study / Qualitative research Topics: Long Covid Limits: Adult / Aged / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: BMC Psychiatry Journal subject: Psychiatry Year: 2022 Document Type: Article Affiliation country: S12888-022-04026-7