Risk of severe COVID-19 infection in individuals with severe mental disorders, substance use disorders, and common mental disorders

Abstract

Objective

To evaluate the risk of severe COVID-19 in individuals with severe mental disorders, substance use disorders, and common mental disorders in the total adult population of Region Stockholm (N = 1,516,270), and to explore possible underlying mechanisms to the increased risk.

Methods

In this prospective cohort study, we examined the risk of hospitalization and treatment in an intensive care unit (ICU) with COVID-19, and death from COVID-19 for individuals with mental disorders. Associations were step by step adjusted for (1) sociodemographic/economic factors, (2) indicators of virus exposure, (3) somatic conditions, and (4) psychopharmacological treatment.

Results

In model 1 (adjusted for age, sex and living in a care home for elderly people), people with a mental disorder had increased risks for inpatient care (HR = 1.5), ICU care (HR = 1.5), and mortality (HR = 1.4) from COVID-19. There was an increased risk of dying from COVID-19 in all subgroups of mental disorders, particularly in people with a severe mental disorder (HR = 1.9). Different covariates had different effects on the association depending on the outcome and on sex, age, or psychiatric diagnosis of the participants.

Conclusion

People with mental disorders have an increased risk of severe COVID-19, including mortality. The increased risk was partly explained by the examined covariates.