Division of Psychology and Mental Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9PL, UK.
Centre for Health Informatics, Division of Informatics, Imaging and Data Sciences, The University of Manchester, M13 9PL, UK.
Schizophr Bull. 2023 Mar 15;49(2):275-284. doi: 10.1093/schbul/sbac118.
Previous studies show that people with severe mental illness (SMI) are at higher risk of COVID-19 mortality, however limited evidence exists regarding risk postvaccination. We investigated COVID-19 mortality among people with schizophrenia and other SMIs before, during and after the UK vaccine roll-out.
Using the Greater Manchester (GM) Care Record to access routinely collected health data linked with death records, we plotted COVID-19 mortality rates over time in GM residents with schizophrenia/psychosis, bipolar disorder (BD), and/or recurrent major depressive disorder (MDD) from February 2020 to September 2021. Multivariable logistic regression was used to compare mortality risk (risk ratios; RRs) between people with SMI (N = 193 435) and age-sex matched controls (N = 773 734), adjusted for sociodemographic factors, preexisting comorbidities, and vaccination status.
Mortality risks were significantly higher among people with SMI compared with matched controls, particularly among people with schizophrenia/psychosis (RR 3.18, CI 2.94-3.44) and/or BD (RR 2.69, CI 2.16-3.34). In adjusted models, the relative risk of COVID-19 mortality decreased, though remained significantly higher than matched controls for people with schizophrenia (RR 1.61, CI 1.45-1.79) and BD (RR 1.92, CI 1.47-2.50), but not recurrent MDD (RR 1.08, CI 0.99-1.17). People with SMI continued to show higher mortality rate ratios relative to controls throughout 2021, during vaccination roll-out.
People with SMI, notably schizophrenia and BD, were at greater risk of COVID-19 mortality compared to matched controls. Despite population vaccination efforts that have prioritized people with SMI, disparities still remain in COVID-19 mortality for people with SMI.
先前的研究表明，患有严重精神疾病（SMI）的人群患 COVID-19 死亡率更高，然而，关于疫苗接种后的风险，证据有限。我们调查了英国疫苗接种推广前后，精神分裂症和其他 SMI 患者的 COVID-19 死亡率。
使用大曼彻斯特（GM）护理记录来获取与死亡记录相关的常规收集健康数据，我们绘制了 2020 年 2 月至 2021 年 9 月期间 GM 地区患有精神分裂症/精神病、双相情感障碍（BD）和/或复发性重度抑郁症（MDD）的居民的 COVID-19 死亡率随时间的变化情况。多变量逻辑回归用于比较 SMI 患者（N=193435）和年龄性别匹配对照者（N=773734）之间的死亡率风险（风险比；RR），并针对社会人口因素、预先存在的合并症和疫苗接种状态进行了调整。
与匹配对照者相比，SMI 患者的死亡率风险显著更高，尤其是患有精神分裂症/精神病（RR 3.18，CI 2.94-3.44）和/或 BD（RR 2.69，CI 2.16-3.34）的患者。在调整后的模型中，COVID-19 死亡率的相对风险降低，但与匹配对照者相比，精神分裂症（RR 1.61，CI 1.45-1.79）和 BD（RR 1.92，CI 1.47-2.50）患者的风险仍然显著更高，但复发性 MDD 患者则不然（RR 1.08，CI 0.99-1.17）。在 2021 年疫苗接种推广期间，SMI 患者的死亡率比率相对于对照组仍然较高。
与匹配对照者相比，患有 SMI 的人群，尤其是精神分裂症和 BD 患者，COVID-19 死亡率更高。尽管人群疫苗接种工作优先考虑 SMI 患者，但 COVID-19 死亡率在 SMI 患者中仍然存在差异。
