Written & Researched By Kamya Patel
Ever since the start of the COVID-19 pandemic, there has been a significant rise in mental health problems. Along with causing widespread anxiety and depression, COVID-19 itself has been proven to be affected by a mental health disorder: schizophrenia. To be specific, schizophrenia is a chronic brain disorder characterized by delusions and hallucinations as well as distorted thinking, emotions, language, behavior, and perception. Schizophrenia not only leads to other physical illnesses but also has an effect on educational and occupational performance. Plus, schizophrenic patients are subject to stigma, discrimination, and violation of human rights.
According to several studies, including ones in South Korea, France, and Israel, there is a higher prevalence of COVID-19 in schizophrenia patients. Researchers at New York University (NYU) Grossman School of Medicine also found that schizophrenia is the second greatest risk factor for COVID-19 deaths. In fact, the NYU study suggested that people with schizophrenia are almost three times as likely to die of COVID-19 than those without the disorder. In comparison, other mental health issues, such as mood or anxiety disorders, did not cause an increased risk of death from infection of COVID-19. In order to arrive at this conclusion, “...the research team analyzed 7,348 patient records of men and women treated for COVID-19 at the height of the pandemic in NYU Langone hospitals...they identified 14 percent who were diagnosed with schizophrenia, mood disorders, or anxiety. Then, the researchers calculated patient death rates within 45 days of testing positive for the virus” (“Schizophrenia Second Only to Age as Greatest Risk Factor for Covid-19 Death”).
As suggested by Dr. Katlyn Nemani, MD, the lead author of the study and a psychiatrist at NYU Grossman School of Medicine, schizophrenic COVID-19 patients are more likely to experience severe symptoms due to underlying dysfunction of the immune system. In schizophrenia, particular risk genes and environmental stressors alter the body’s immune response to create a long-term pro-inflammatory state, meaning an overactive immune system leads to extensive tissue damage. The immune activity linked to schizophrenia increases the danger of a cytokine storm, an overactive immune system. This would make it harder to fight off infection because of complications like oxidative stress and impaired energy production. Plus, the presence of the COVID-19 virus would trigger an inflammatory response from the immune system in addition to the hyperinflammation already included in schizophrenia. Furthermore, a common occurrence between schizophrenia and COVID-19 patients has been reduced levels of natural killer (NK) cells that assist with early antiviral immunity. As a result, “higher viral loads can attenuate the immune response in people with schizophrenia due to reduced NK activity, exposing them to severe infection” (Mohan 2021). In sum, the significant immunomodulation brought about by the combination of schizophrenia and COVID-19 is a reason for the increased morbidity and mortality rates.
In addition, the study’s senior author and director of the Nathan S. Kline Institute for Psychiatric Research, Donald Goff, MD, mentioned that the researchers plan to further investigate whether medications used for the treatment of schizophrenia, such as antipsychotic drugs, play a role in escalating the severity of COVID-19. For now, however, knowing that schizophrenia makes patients more vulnerable to COVID-19 is an important finding to help healthcare providers prioritize such high-risk patients for vaccine distribution and medical aid.
References:
Mann, Denise. “COVID Especially Risky With Schizophrenia.” WebMD, WebMD, 28 Jan. 2021, www.webmd.com/lung/news/20210128/covid-especially-risky-with-schizophrenia#1. Accessed 19 September 2021.
Meissner, Morgan. “In the News: Schizophrenia May Increase the Risk of Death from COVID-19.” Medical News Today, www.medicalnewstoday.com/articles/schizophrenia-increases-covid-death-risk. Accessed 19 September 2021.
Mohan, Mohapradeep et al. “COVID-19 in People With Schizophrenia: Potential Mechanisms Linking Schizophrenia to Poor Prognosis.” Frontiers in psychiatry vol. 12 666067. 17 May. 2021, doi:10.3389/fpsyt.2021.666067, www.ncbi.nlm.nih.gov/pmc/articles/PMC8166317/. Accessed 19 September 2021.
“Schizophrenia Second Only to Age as Greatest Risk Factor for COVID-19 Death.” NYU Langone Health, 27 Jan. 2021, nyulangone.org/news/schizophrenia-second-only-age-greatest-risk-factor-covid-19-death. Accessed 19 September 2021.
“Schizophrenia.” World Health Organization, World Health Organization, 4 Oct. 2019, www.who.int/news-room/fact-sheets/detail/schizophrenia. Accessed 19 September 2021.