Dagnaw Gashaw Getaneh, Paltiel Ora, Shafrir Asher
College of Veterinary Medicine and Animal Sciences, Department of Epidemiology and Public Health, University of Gondar, Gondar, Ethiopia.
Braun School of Public Health and Community Medicine, Jerusalem, Israel.
Soc Psychiatry Psychiatr Epidemiol. 2025 Aug;60(8):2013-2022. doi: 10.1007/s00127-025-02860-0. Epub 2025 Mar 3.
Severe mental illness may affect health behaviors and outcomes during pandemics. Few studies have assessed whether people living with schizophrenia spectrum disorders (SSD) experienced adverse COVID-19 outcomes.
In a population-based historical cohort study comprising members of a health maintenance organization, we included 1273 patients with SSD and 12,730 age- and sex-matched controls tested for SARS-CoV-2 between March 2020 and May 2022. We assessed the association between schizophrenia and hospitalization, hospital length-of-stay, 30-day, and one-year mortality, constructing multiple linear regression and logistic regression models adjusting for sociodemographic factors, BMI, smoking, number of comorbidities, and vaccinations. We also assessed whether vaccination modified the association between schizophrenia and mortality.
Among patients with SSD, 477 (37.5%) had a positive test, compared to 6203 (48.7%) in the comparison group. patients with SSD were at increased risk of hospitalization (adjusted odds ratio (OR) 3.44, 95% confidence interval (CI): 2.88-4.11, p < 0.001); longer length-of-stay (β = 1.20, p < 0.001); increased 30-day (OR 9.07, 95%CI 3.11-26.44); and one-year mortality (OR 6.27, 95%CI: 2.73-14.39). Further adjustment for vaccination altered the OR for 30-day mortality (OR 4.54, 95%CI: 1.54-13.38). Additionally, the association between schizophrenia and 30-day mortality was attenuated in strata of vaccinated (OR 4.79, 95%CI: 0.82-28.13, p = 0.082), vs. unvaccinated individuals (OR 7.53, 95%CI 2.19-25.92, p = 0.001), respectively.
In our cohort, patients with SSD experienced a significantly higher rate of hospitalization, length of stay, and mortality following a positive SARS-CoV-2 test, even after adjusting for important prognostic factors. COVID-19 vaccination modified these risks.
严重精神疾病可能会影响大流行期间的健康行为和结果。很少有研究评估精神分裂症谱系障碍（SSD）患者是否经历了不良的新冠病毒疾病（COVID-19）结局。
在一项基于人群的历史性队列研究中，该研究纳入了一个健康维护组织的成员，我们纳入了1273例SSD患者和12730例年龄和性别匹配的对照，这些对照在2020年3月至2022年5月期间接受了新冠病毒2（SARS-CoV-2）检测。我们评估了精神分裂症与住院、住院时长、30天和一年死亡率之间的关联，构建了多元线性回归和逻辑回归模型，并对社会人口学因素、体重指数（BMI）、吸烟、合并症数量和疫苗接种情况进行了调整。我们还评估了疫苗接种是否改变了精神分裂症与死亡率之间的关联。
在SSD患者中，477例（37.5%）检测呈阳性，而对照组为6203例（48.7%）。SSD患者住院风险增加（调整后的优势比（OR）为3.44，95%置信区间（CI）：2.88 - 4.11，p < 0.001）；住院时长更长（β = 1.20，p < 0.001）；30天死亡率增加（OR为9.07，95%CI为3.11 - 26.44）；一年死亡率增加（OR为6.27，95%CI：2.73 - 14.39）。对疫苗接种情况进行进一步调整后，30天死亡率的OR发生了变化（OR为4.54，95%CI：1.54 - 13.38）。此外，在接种疫苗的人群中（OR为4.79，95%CI：0.82 - 28.13，p = 0.082），与未接种疫苗的个体（OR为7.53，95%CI为2.19 - 25.92，p = 0.001）相比，精神分裂症与30天死亡率之间的关联减弱。
在我们的队列中，即使在对重要的预后因素进行调整后，SSD患者在SARS-CoV-2检测呈阳性后，住院率、住院时长和死亡率仍显著更高。COVID-19疫苗接种改变了这些风险。
