Mental health issues linked to higher risk of breakthrough COVID infections | Health info

By Denise Mann Health Day Reporter

(Health Day)

MONDAY, April 18, 2022 (HealthDay News) — People with substance use disorders, depression and other mental health conditions may be at higher risk for COVID-19 — even when fully vaccinated, says new research.

“People with psychiatric disorders, and particularly older adults with psychiatric disorders, may be particularly vulnerable to breakthrough infections,” said study author Kristen Nishimi, a postdoctoral fellow at the San Francisco Veterans Affairs Medical Center and at the University of California, San Francisco. “Mental health should be recognized as another important factor to consider when thinking about the risk of COVID-19 infection.”

While the new study only found an association and was not designed to say why breakthrough infections may be more likely in people with psychiatric illnesses, researchers have some theories.

“People with psychiatric disorders may have more impaired cellular immunity and blunted responses to vaccines, compared to people without psychiatric disorders, which may result in less effective responses to SARS-CoV-2 vaccines,” said Nishimi.

Additionally, these people may also be more likely to engage in risky behaviors or be in situations that require more interpersonal interactions, which increases their risk for COVID, she said.

For the study, researchers reviewed the records of more than 263,000 US Department of Veterans Affairs patients (average age: 66). Most of the participants were men, all were fully vaccinated, and all had at least one COVID test.

Just over half had been diagnosed with a psychiatric disorder and 14.8% developed a breakthrough infection that was confirmed by a positive COVID test, the study showed.

Overall, people with mental illnesses had 3% higher risk than others for the COVID breakthrough in 2021.

People with substance abuse or adjustment disorders — an overly emotional reaction to a stressful event or life change — were at particularly high risk, the study found.

Overall, the increased risk was highest among people 65 and older with psychiatric illnesses — findings that held when the researchers controlled for other factors that affect COVID risk, including obesity, diabetes, heart disease and cancer.

Nishimi said providers who treat mental health conditions should be aware of this increased risk of breakthrough infections in patients with psychiatric disorders.

“More preventive measures like booster vaccinations or increased screening for SARS-CoV-2 could be considered for these people, she said.

Outside experts agree that people with mental illness and those who care for them should do more to prevent COVID-19.

“Like diabetes, heart disease and other underlying conditions, mental health disorders also put people in a higher risk category for COVID-19,” said Dr. Len Horovitz, a pulmonologist at the Lenox Hill Hospital in New York.

The new findings make sense, said Dr. John Krystal, chief of psychiatry at Yale-New Haven Hospital.

“Obesity is a risk for COVID-19 because it produces inflammation in the body and affects immune function, and depression does the same,” Krystal said. “In major depression, you get inflammation in the brain and the body.”

Additionally, people with mental health issues may be less able to take the necessary steps to prevent infection.

Previous studies — including one by Yale researchers early in the pandemic — showed that people with a history of psychiatric disorders were more likely to die from COVID than their counterparts without such a history.

“The pandemic is not over yet, and all of us, especially people with mental illnesses, must continue to take steps to prevent COVID-19 infection,” Krystal said.

SOURCES: Kristen Nishimi, PhD, postdoctoral fellow, psychology, San Francisco Veterans Medical Center and University of California, San Francisco; John Krystal, MD, professor, translational research, psychiatry, neuroscience, and psychology, Yale School of Medicine, co-director, Yale Center for Clinical Investigation, and chief, psychiatry, Yale-New Haven Hospital, New Haven, Connecticut; Len Horovitz, MD, pulmonologist, Lenox Hill Hospital, New York; Open JAMA NetworkApril 14, 2022

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