Patients with Severe Mental Illness at Increased Mortality Risk with COVID-19 infection

A new study delves into the association between COVID-19 and mortality in individuals with severe mental illness (SMI) and investigates the role of multimorbidity and ethnicity in this context. This study was published in The British Journal Of Psychiatry by Jayati Das and colleagues.

The study, which examined data from February 2020 to April 2021, sought to shed light on the impact of SMI on all-cause mortality during the initial two waves of the COVID-19 pandemic. The research, a retrospective cohort study, analyzed primary care data from the Clinical Practice Research Database.

The findings revealed that among the 7,146 individuals with SMI in the study (56% female), there was a notably higher prevalence of multimorbidity compared to a control group without SMI, consisting of 653,024 individuals (55% female).

The study found that following COVID-19 infection, individuals with SMI faced a significantly higher risk of death compared to those without SMI, with an adjusted hazard ratio of 1.53.

Ethnicity also played a significant role in the outcomes. The study found that Black Caribbean/Black African individuals had a higher likelihood of mortality due to COVID-19 compared to White individuals. Importantly, this racial disparity was similar in both the SMI group and the control group without SMI.

Moreover, the research highlighted the influence of multimorbidity on COVID-19 mortality. For every additional multimorbidity condition, the adjusted hazard ratio for death increased by 1.06 in the SMI group and 1.16 in the non-SMI group. This suggests that multimorbidity further compounded the risk of mortality.

In conclusion, the study underscores the increased risk of death from COVID-19 in individuals with severe mental illness, particularly when they also contend with multiple comorbidities. It also highlights racial disparities in COVID-19 mortality, with Black Caribbean/Black African individuals facing a higher risk. Importantly, these disparities were consistent across both the SMI and non-SMI groups. These findings underline the importance of considering these factors when developing strategies to combat the ongoing pandemic.

Reference:

Das-Munshi, J., Bakolis, I., Bécares, L., Dyer, J., Hotopf, M., Ocloo, J., Stewart, R., Stuart, R., & Dregan, A. Severe mental illness, race/ethnicity, multimorbidity and mortality following COVID-19 infection: nationally representative cohort study. The British Journal of Psychiatry: The Journal of Mental Science,2023;223(5):518–525. https://doi.org/10.1192/bjp.2023.112