Mental illness increases risk of breakthrough COVID infections

A new study led by the University of California, San Francisco (UCSF) has found that people who are vaccinated against SARS-CoV-2 and have a history of certain psychiatric conditions are at a higher risk of developing breakthrough infections. According to the scientists, this phenomenon may be caused by impaired immune responses, as well as risky behaviors associated with some mental disorders.

The researchers investigated a cohort of 263,697 fully vaccinated United States Department of Veterans Affairs patients who had at least one SARS-CoV-2 test recorded in the electronic health record, and had no history of SARS-CoV-2 infection prior to vaccination. They found that patients over 65 with psychiatric disorders had a heightened risk of up to 24 percent for breakthrough infections. 

The risks were higher for people with substance abuse disorder (24 percent), followed by those with psychotic (23 percent), bipolar (16 percent), adjustment (14 percent), and anxiety (12 percent) disorders. For younger participants with psychiatric issues, the risks were up to 11 percent higher than for those without a history of mental illness. 

For both age groups, data was adjusted for sex, age, race, ethnicity, and vaccine type, as well as for various comorbidities, including obesity, diabetes, HIV, cancer, sleep apnea, or cardiovascular, lung, kidney, and liver diseases.

“Our research suggests that increased breakthrough infections in people with psychiatric disorders cannot be entirely explained by socio-demographic factors or pre-existing conditions,” said study senior author Aoife O’Donovan, an associate professor of Psychiatry at UCSF. “It’s possible that immunity following vaccination wanes more quickly or more strongly for people with psychiatric disorders and/or they could have less protection to newer variants.”

Moreover, according to a previous study published in the journal Preventive Medicine Reports, individuals with elevated anxiety levels and post-traumatic stress disorder – conditions associated with increased impulsivity – were more likely to engage in various behaviors that put them at higher risk for COVID-19. 

These findings suggest that psychiatric disorders should be considered highly significant factors for SARS-CoV-2 breakthrough infections. “Mental health is important to consider in conjunction with other risk factors, and some patients should be prioritized for boosters and other critical preventive efforts,” concluded Professor O’Donovan.

The study is published in the journal JAMA Network Open. 

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By Andrei Ionescu, Earth.com Staff Writer