Schizophr Bull. 2023 Sep 7;49(5):1399-1403. doi: 10.1093/schbul/sbad036.
Previous studies show that people with severe mental illness (SMI) are at higher risk of COVID-19 mortality, however limited evidence exists regarding risk post-vaccination. 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=190,188) and age-sex matched controls (N=760,752), adjusted for sociodemographic factors, pre-existing comorbidities and vaccination status.
Mortality risks were significantly higher among people with SMI compared with matched controls, particularly among people with schizophrenia/psychosis (RR 3.14, CI 2.66-3.71) and/or BD (RR 3.17, CI 2.15-4.67). In adjusted models, the relative risk of COVID-19 mortality decreased, though remained significantly higher than matched controls for people with schizophrenia (RR 1.53, CI 1.24-1.88) and BD (RR 2.28, CI 1.49-3.49), but not recurrent MDD (RR 0.92, CI 0.78-1.09). 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 bipolar disorder, were at greater risk of COVID-19 mortality compared to matched controls. Despite population vaccination efforts that have prioritised people with SMI, disparities still remain in COVID-19 mortality for people with SMI.
既往研究表明,重症精神疾病(SMI)患者的新冠病毒病(COVID-19)死亡风险更高,但关于接种疫苗后的风险证据有限。我们调查了英国疫苗接种推广前、期间和之后,精神分裂症患者及其他重症精神疾病患者的COVID-19死亡率。
利用大曼彻斯特(GM)护理记录获取与死亡记录相关的常规收集的健康数据,我们绘制了2020年2月至2021年9月GM地区精神分裂症/精神病、双相情感障碍(BD)和/或复发性重度抑郁症(MDD)患者的COVID-19死亡率随时间的变化情况。采用多变量逻辑回归比较重症精神疾病患者(N=190,188)与年龄和性别匹配的对照组(N=760,752)的死亡风险(风险比;RRs),并对社会人口学因素、既往合并症和疫苗接种状况进行了调整。
与匹配的对照组相比,重症精神疾病患者的死亡风险显著更高,尤其是精神分裂症/精神病患者(RR 3.14,CI 2.66 - 3.71)和/或双相情感障碍患者(RR 3.17,CI 2.15 - 4.67)。在调整模型中,COVID-19死亡的相对风险有所降低,但精神分裂症患者(RR 1.53,CI 1.24 - 1.88)和双相情感障碍患者(RR 2.28,CI 1.49 - 3.49)的相对风险仍显著高于匹配的对照组,而复发性重度抑郁症患者则不然(RR 0.92,CI 0.78 - 1.