In summary, the study finds that people vaccinated once morest SARS-CoV-2 and with a history of psychiatric conditions are also at increased risk for COVID-19. This finding might be explained by a weakened immune response as well as the risky behaviors associated with some of these disorders.
The study: the UCSF team with colleagues from the San Francisco VA Health Care System followed more than 250,000 US Department of Veterans Affairs patients, with an average age of 66 and 90% male, who had completed their vaccination schedule. Just over half (51.4%) of patients had received at least one psychiatric diagnosis in the past 5 years and 14.8% developed a breakthrough COVID-19 infection, confirmed by a positive test. The team took into account possible confounding factors, including age, sex, ethnicity and type of vaccine used, as well as smoking history and comorbidities such as obesity, diabetes, sleep apnea, cardiovascular, lung, kidney and liver disease, HIV and cancer. The analysis shows precisely that:
- patients over the age of 65 with substance abuse, psychotic disorders, bipolar disorder, adjustment disorder and anxiety disorders, face
a 24% increased incidence of “breakthrough infections” or infections occurring following vaccination;
- an incidence for people under 65 suffering from the same mental disorders, increased by 11% of breakthrough infections;
- an increased risk of 24% for drug addicts over 65,
- a 23% increased risk for participants with psychotic disorders,
- an increased risk of 16% for participants with bipolar disorder, 14% with adjustment disorder and 12% with anxiety disorders.
- For other comorbidities, the incidence increases are 23% for chronic kidney disease, 20% for HIV, 19% for cardiovascular disease, 18% for chronic lung disease and 13% for sleep apnea.
What explanations? If, in the general population, the resumption of infections, post-vaccination, is explained by a decreasing immunity and a lower protection once morest the new variants, this particular increase in infections in people with psychiatric disorders cannot be explained by these factors alone or by socio-demographic factors or pre-existing (other than mental) conditions, comments lead author Dr. Aoife O’Donovan of the UCSF Weill Institute for Neurosciences.
It is possible that post-vaccination immunity wanes more quickly or sharply in these people with psychiatric disorders and/or they might have particularly reduced protection once morest new variants, due to treatments, or they might be more likely engage in behaviors that put them at higher risk for COVID. Finally, it is possible that these elderly patients with psychiatric disorders may require more frequent in-person care, which might increase their interactions with the health care system and therefore their risk of infection.
Thus, certain psychiatric conditions, in particular in the group of 65 years and over, must be taken into account among the risk factors in the same way as other more often mentioned comorbidities, including obesity or heart disease.
