COVID-19 prevalence and mortality among schizophrenia patients: A large-scale retrospective cohort study

Dana Tzur Bitan, Israel Krieger, Khalaf Kridin, Doron Komantscher, Yochai Scheinman, Orly Weinstein, Arnon Dov Cohen, Assi Albert Cicurel, Daniel Feingold

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76 Scopus citations

Abstract

Objective: Individuals with schizophrenia may be at an increased risk for COVID-19 morbidity due to the disease characteristics. In this study, we aimed to explore the odds of significant COVID-19 morbidity and mortality among schizophrenia patients while controlling for potential sociodemographic and medical confounders. Methods: Schizophrenia patients and age-and-sex matched controls (total n = 51 078) were assessed for frequency of COVID-19 positivity, hospitalizations, and mortality. The odds for COVID-19-associated hospitalization and mortality were calculated using logistic regression models, while controlling for age, sex, marital status, sector, socioeconomic status, diabetes, ischemic heart disease, hypertension, hyperlipidemia, obesity, smoking, and chronic obstructive pulmonary disease. Results: Individuals with schizophrenia were less likely to test positive for COVID-19; however, they were twice as likely to be hospitalized for COVID-19 (OR 2.15 95% CI 1.63-2.82, P <. 0001), even after controlling for sociodemographic and clinical risk factors (OR 1.88 95% CI 1.39-2.55, P <. 0001). Furthermore, they were 3 times more likely to experience COVID-19 mortality (OR 3.27 95% CI 1.39-7.68, P <. 0001), compared to controls. Conclusions: We found evidence of associations between schizophrenia and increased COVID-19 morbidity and mortality compared to controls regardless of sociodemographic and medical factors. As these patients present with a combination of potential risk factors for mortality, efforts should be made to minimize the effects of the pandemic on this vulnerable population.

Original languageEnglish
Pages (from-to)1211-1217
Number of pages7
JournalSchizophrenia Bulletin
Volume47
Issue number5
DOIs
StatePublished - 21 Aug 2021
Externally publishedYes

Bibliographical note

Publisher Copyright:
© The Author(s) 2021.

Funding

The authors have declared that there are no conflicts of interest in relation to the subject of this study. Other financial relations are as follows: Prof. A.D.C. received research grants from Janssen, Novartis, AbbVie, Janssen and Sanofi. Prof. A.D.C. served as a consultant, advisor or speaker to AbbVie, Amgen, Boehringer Ingelheim, Dexcel pharma, Janssen, Kamedis, Lilly, Neopharm, Novartis, Perrigo, Pfizer, Rafa, Samsung Bioepis, Sanofi, Sirbal and Taro. Dr. D.T.B. received an independent research grant from Pfizer in the field of dermatology. All other authors have no other financial relations to declare.

FundersFunder number
Dexcel pharma
Pfizer
Novartis
Boehringer Ingelheim
Janssen Pharmaceuticals

    Keywords

    • COVID-19
    • Cohort
    • Hospitalization
    • Mortality
    • Schizophrenia

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