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Severe Mental Illness Upped Risk of Death After Positive COVID-19 Test

Jolynn Tumolo

During the first year of the pandemic, people with severe mental illness (SMI) had a 50% greater risk of all-cause death following COVID-19 infection compared to people without serious mental illness, according to study results published in the British Journal of Psychiatry.

“From a public health perspective, our study has emphasized the need for early and timely preventative interventions (eg, vaccination) for the SMI population,” wrote researchers from King’s College London in the United Kingdom. “Future studies are needed to disentangle the complex biological and psychosocial factors, and health care pathways, that have led to the greater mortality rates in the SMI population.”

The nationally representative cohort study included 660,517 people who tested positive for COVID-19 between February 2020 and April 2021 in the United Kingdom. Among them, 7146 had serious mental illness, such as schizophrenia or psychosis. The study period spanned the first 2 waves of the pandemic.

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After contracting COVID-19, the adjusted hazard ratio for death for people with SMI was 1.53 compared with people without SMI, according to the study. By pandemic wave, adjusted hazard ratios for all-cause death among people with SMI were 1.71 during the initial wave and 1.40 during the second wave.

The adjusted hazard ratio for death after COVID-19 was 1.22 for people who were Black Caribbean/Black African compared with people who were white, and was similar for people with and without SMI, the study found. However, ethnicity was not recorded in nearly a third of patient data.

With each additional multimorbidity condition, the risk of death after a positive COVID-19 test increased 6% for people with SMI and 16% for people without SMI, researchers reported.

“Previous research has shown that these health inequalities exist, but our study really demonstrates how the pandemic has exacerbated them,” said study senior author Alex Dregan, PhD, senior lecturer in psychiatric epidemiology at King’s College London. “We now need to try to understand why this is happening and see if there is a pattern in how these people do or do not seek and access services.”

 

References

Das-Munshi J, Bakolis I, Bécares L, et al. Severe mental illness, race/ethnicity, multimorbidity and mortality following COVID-19 infection: nationally representative cohort study. Br J Psychiatry. Published online October 25, 2023. doi:10.1192/bjp.2023.112

People with severe mental illness at 50 per cent higher risk of death following COVID-19 infection. News release. King’s College London; October 25, 2023. Accessed October 30, 2023.

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