COVID-19 in People With Schizophrenia: Potential Mechanisms Linking Schizophrenia to Poor Prognosis
Mohapradeep Mohan1, Benjamin Ian Perry2, Ponnusamy Saravanan3,4
1Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, United Kingdom.
Insights
People with schizophrenia face higher risks of severe COVID-19 outcomes. Understanding the underlying mechanisms is crucial for developing targeted prevention and treatment strategies for this vulnerable population.
Area of Science:
- Infectious Diseases
- Psychiatry
- Public Health
Background:
- COVID-19 poses a significant global health threat, with mortality rates rising.
- Established risk factors for severe COVID-19 include age and cardiometabolic, renal, and respiratory diseases.
- Emerging evidence suggests individuals with schizophrenia have increased susceptibility and risk of adverse COVID-19 outcomes, irrespective of age and comorbidities.
Purpose of the Study:
- To review the current understanding of COVID-19 in patients with schizophrenia.
- To propose potential pathophysiological mechanisms linking schizophrenia to increased COVID-19 susceptibility and adverse outcomes.
- To highlight the need for further research to inform prevention and treatment strategies.
Main Methods:
- Narrative review of existing literature on COVID-19 and schizophrenia.
- Synthesis of current knowledge regarding potential biological and clinical links.
- Identification of knowledge gaps and areas for future investigation.
Main Results:
- Schizophrenia is associated with a heightened risk of severe COVID-19 outcomes.
- Potential mechanisms include immune dysregulation, shared genetic factors, and lifestyle influences.
- Existing research is insufficient to fully elucidate these complex interactions.
Conclusions:
- Elucidating the mechanisms underlying increased COVID-19 risk in schizophrenia is critical.
- Further robust clinical and biological studies are essential.
- Developing targeted prevention and treatment strategies for this population is a priority.
Abstract:
As the global burden of mortality from COVID-19 continues to rise, an understanding of who is most at risk of adverse outcomes is of paramount importance. Pre-existing cardiometabolic, renal and respiratory diseases as well as old age are well-established risk factors associated with disease severity and mortality among patients with COVID-19. However, mounting evidence also indicates an increased susceptibility to, and risk of adverse outcomes from COVID-19 in people with schizophrenia, independent of age and comorbidity. Therefore, elucidating the underlying pathophysiological mechanisms which may increase the risk of poor outcomes in people with schizophrenia is of crucial importance. Here, we provide a narrative on the current understanding of COVID-19 in patients with schizophrenia and propose potential mechanisms which may link schizophrenia with an increased susceptibility to, and greater risk of adverse outcomes from COVID-19. Given the existing knowledge gaps, robust clinical and biological studies are required to further our understanding of some of these underlying mechanisms, so that effective prevention and treatment strategies for COVID-19 in patients with schizophrenia can be developed.
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