Mohan Mohapradeep, Perry Benjamin Ian, Saravanan Ponnusamy, Singh Swaran Preet
Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, United Kingdom.
Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom.
Front Psychiatry. 2021 May 17;12:666067. doi: 10.3389/fpsyt.2021.666067. eCollection 2021.
As the global burden of mortality from COVID-19 continues to rise, an understanding of who is most at risk of adverse outcomes is of paramount importance. Pre-existing cardiometabolic, renal and respiratory diseases as well as old age are well-established risk factors associated with disease severity and mortality among patients with COVID-19. However, mounting evidence also indicates an increased susceptibility to, and risk of adverse outcomes from COVID-19 in people with schizophrenia, independent of age and comorbidity. Therefore, elucidating the underlying pathophysiological mechanisms which may increase the risk of poor outcomes in people with schizophrenia is of crucial importance. Here, we provide a narrative on the current understanding of COVID-19 in patients with schizophrenia and propose potential mechanisms which may link schizophrenia with an increased susceptibility to, and greater risk of adverse outcomes from COVID-19. Given the existing knowledge gaps, robust clinical and biological studies are required to further our understanding of some of these underlying mechanisms, so that effective prevention and treatment strategies for COVID-19 in patients with schizophrenia can be developed.
随着新冠病毒疾病(COVID-19)导致的全球死亡负担持续上升,了解哪些人最易出现不良后果至关重要。既往存在的心脏代谢、肾脏和呼吸系统疾病以及高龄是与COVID-19患者疾病严重程度和死亡率相关的公认风险因素。然而,越来越多的证据还表明,精神分裂症患者对COVID-19的易感性增加,且出现不良后果的风险更高,这与年龄和合并症无关。因此,阐明可能增加精神分裂症患者不良后果风险的潜在病理生理机制至关重要。在此,我们阐述了目前对精神分裂症患者感染COVID-19的认识,并提出了可能将精神分裂症与对COVID-19易感性增加及不良后果风险更高联系起来的潜在机制。鉴于目前存在的知识空白,需要开展有力的临床和生物学研究,以进一步了解其中一些潜在机制,从而制定出针对精神分裂症患者的COVID-19有效预防和治疗策略。