August 11, 2021

2 minutes to read

Disclosures: Bitan reports receiving a research grant from Pfizer and the American Psychological Foundation. Please see the study for relevant financial information from all other authors. De Picker does not report any relevant financial information.


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People with schizophrenia had lower COVID-19 vaccination rates than the general population despite a higher risk of hospitalization and death, according to the results of a longitudinal cohort study.

“In two cross-sectional studies published in 2021, we reported an association between schizophrenia and hospitalization and mortality from COVID-19, as well as an association between schizophrenia and a lower likelihood of getting vaccinated. ” Dana Tzur Bitan, doctorate, from the Behavioral Sciences Department of Ariel University in Israel, and his colleagues wrote in Lancet Psychiatry. “Nonetheless, to the best of our knowledge, no study has previously assessed longitudinal trends in these effects over time in this patient population. As such, this study aimed to provide a longitudinal assessment of hospitalization, mortality, and vaccination, as well as to assess pre- and post-vaccination outcomes.

Infographic data derived from: Bitan DT, et al. Lancet Psychiatry. 2021; doi: 10.1016 / S2215-0366 (21) 00256-X.

Researchers assessed pre- and post-vaccination outcomes in 25,539 people with schizophrenia compared with 25,539 controls (of total participants, 61% male; mean age, 51.94 years) in Israel through April 30. They conducted Cox and Kaplan proportional hazard regression models. -Meier analyzes to assess longitudinal trends. They obtained data through the databases of Israel’s largest healthcare organization. A total of 75.9% of the sample was from the general Jewish population, 19.1% from the Arab population and 5.1% from the ultra-Orthodox Jewish population.

Among the overall study population, 356 (0.7%) people had been hospitalized, 133 (0.3%) had died and 27,400 (53.6%) had been vaccinated. People with schizophrenia had an increased risk of hospitalization for COVID-19 (HR = 4.81; 95% CI, 3.57-6.48) and mortality (HR = 2.52; 95% CI , 1.64 to 3.85), as well as a more significant decline in survival as time progressed. Those in the control group had a more pronounced tilt in the likelihood of vaccination. Significant predictors of vaccination rates in the schizophrenia group included medical comorbidity of diabetes, hypertension, obesity, or ischemic heart disease (all, P <.0001 however these did not serve as significant predictors among the control group. although disparities in hospitalization and mortality remained higher people with schizophrenia who had been vaccinated compared to controls incidence rates="6.2" respectively they decreased considerably fully groups rate="1.1">

“This study did not control for psychiatric clinical factors such as drug exposure, duration of illness, or inpatient status,” Bitan and colleagues wrote. “Future studies should assess the predictive effect of these factors on vaccination rates. Taken together, the results underscore the importance of facilitating better prevention strategies for people with serious mental illnesses, in order to provide better care for patients with severe mental illnesses.

In a related editorial, Livia J. De Picker, MARYLAND, a psychiatrist and postdoctoral researcher at Duffel University Psychiatric Hospital in Belgium, noted that the pandemic offers a “unique opportunity” for certain psychiatric research opportunities.

“The pandemic provides a unique opportunity to study individual determinants (eg, clinical predictors of risk groups), mental health care (eg, treatment setting) and macro-organizational (eg, system country health) results of COVID-19 and vaccination in patients with mental disorders, ”De Picker wrote. “I see this as a priority in the research agenda of mental health care researchers around the world. Evidence is the prerequisite for effective action, during and after the COVID-19 pandemic. “


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