Schizophrenia is Covid-19’s second biggest risk factor for dying after old age, new research shows.
The mental health condition almost triples the risk of dying from Covid-19 when compared to a healthy person aged between 18 and 44 years.
The only group of people at higher risk of death than those with schizophrenia are the elderly who, regardless of comorbidities, are much more likely to die.
Scientists still don’t fully understand why people with schizophrenia are most at risk, but they believe it may be due to a genetic flaw that inhibits their immune response.
People with schizophrenia tend to live, on average, up to two decades less than people without mental health problems and also suffer from increased illnesses as a result of lack of exercise, obesity, smoking and the side effects of some schizophrenic drugs.
Other conditions that increased the risk of death include heart failure (60 percent increased risk), hypertension (38 percent) and diabetes (27 percent).
Men were found to be 69 percent more at risk of death than women and non-whites (blacks, Asians, browns) were 47 percent more likely to die than whites.
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The mental health condition almost triples the risk of dying from Covid-19 when compared to a healthy person between the ages of 18 and 44. Other conditions that increase the risk of death include heart failure (60 percent increased risk) and high blood pressure ( 38 percent) and diabetes (27 percent)
New York University researchers studied anonymous health records of more than 7,000 patients admitted to Covid-19 between March and May 2020, 75 of whom had clinically diagnosed schizophrenia.
Mortality was defined as death or discharge from hospice within 45 days after a positive coronavirus test result.
“Our findings illustrate that people with schizophrenia are extremely vulnerable to the effects of COVID-19,” says the study’s lead author, Dr. Katlyn Nemani.
“With this new understanding, healthcare providers can better prioritize the distribution of vaccines, tests and medical care for this group.”
Professor Shon Lewis of the University of Manchester, who was not involved in the study, said: ‘It is a good and robust study with important findings.
“We have known for some time that people with schizophrenia in the UK have a reduced life expectancy by 18-20 years compared to the general population.
“This terrible statistic is due in large part to the increased rates of cardiovascular, respiratory and metabolic diseases resulting from lack of exercise, obesity, smoking and side effects of some drugs in people with schizophrenia.
“This latest discovery shows how good preventive care must now be urgently focused on this incredibly vulnerable and disadvantaged population. They must be immediately prioritized for vaccination. ‘
Currently, the United Kingdom’s Joint Vaccination and Immunization Committee has prioritized all people over 50 for the vaccine, as well as health professionals and clinically extremely vulnerable, who are in the fourth priority position ahead of those over 65 years.
This group includes people with ‘severe mental illness’, who are not currently listed as clinically extremely vulnerable, and people who suffer from this condition do not give priority when receiving the vaccine.
The clinically extremely vulnerable group includes chronic kidney disease and diabetes, which confer a 1.23 and 1.27 times greater risk of death from Covid, respectively. This is reduced by the number of 2.67 for schizophrenia.
A spokesman for the Department of Health and Social Care said: ‘The list of conditions used to identify individuals who may be clinically extremely vulnerable has been agreed by the four UK Medical Directors and reflects the most recent evidence available.
“NHS doctors can add any patient to the protected patient list, based on their own clinical judgment and an unbiased assessment of their needs.”
The clinically extremely vulnerable vaccine priority group includes people with chronic kidney disease and diabetes, who have a 1.23 and 1.27 greater risk of dying from Covid than a healthy person. This is decreased by the figure of 2.67 for schizophrenia (stock)
Dr Adrian James, president of the Royal College of Psychiatrists, said: ‘The deadly consequences of Covid-19 in people living with schizophrenia are deeply worrying and should serve as a catalyst to ensure that this group of people at risk receive the vaccine at the first opportunity.
‘Those living in the community should receive support throughout the vaccination process, while those in mental health wards or homes should not be forgotten or left behind.
“People living with a serious mental illness already die an average of 20 years earlier than the general population. The government must do everything in its power to protect people living with Covid-19’s severe mental illness, intellectual disability and dementia. ‘
While people with schizophrenia were at a much higher risk of death, people with anxiety and mood disorders were not.
This, say the researchers, indicates that there may be an unknown underlying mechanism that puts people with schizophrenia at high risk.
Dr. Nemani says this could be a disorder of the immune system, possibly linked to the genetics of the disorder.
“Now that we have a better understanding of the disease, we can further examine which immune system problems, if any, can contribute to the high mortality rates seen in these patients with schizophrenia,” says the study’s senior author, Dr. Donald Goff, from NYU Langone.
Stephen Buckley, head of information at Mind, said: ‘While we accept research on the links between serious mental health problems and Covid19, much more robust research is needed worldwide, including in the UK.
“Research that leads to better health and quality of life results for people with mental health problems is welcome.
‘It has never been more important for people with mental health problems to get the support they need and deserve.
“Anyone diagnosed with schizophrenia and concerned about the impact that coronavirus can have on their health should talk to their doctor to review their situation.
‘In the UK, research has shown links between covid19 and factors like poverty and ethnicity, so it is really important that all of these links are better understood.
“In England, people living with severe mental illness are 4.5 times more likely than the average to die before reaching the age of 75 in England, if they do not receive adequate support, so it is very important that we try understand the reasons behind these poor health outcomes. ‘
The study was published today in JAMA Psychiatry.