Mortality from coronavirus disease 2019 (Covid-19) in patients with schizophrenia: A systematic review, meta-analysis and meta-regression

Gen Hosp Psychiatry. 2022 Mar-Apr:75:61-67. doi: 10.1016/j.genhosppsych.2022.01.010. Epub 2022 Feb 4.

Abstract

Objective: Schizophrenia has been associated with patients' poor quality of life, disability, and hospitalization. As of today, evidence that highlights the association between schizophrenia and coronavirus disease (Covid-19) outcomes remains unclear. This study sought to analyze whether patients with pre-existing schizophrenia are at higher risk for Covid-19 mortality.

Methods: Using specific keywords, we comprehensively searched PubMed, Scopus, OVID, and Cochrane Library sources until November 15th, 2021. All published studies on schizophrenia and Covid-19 were collected. We used Review Manager 5.4 and Comprehensive Meta-Analysis 3 software to conduct statistical analysis.

Results: There were 10 studies with 263,207 Covid-19 patients included in the analysis. Evaluation of the data gathered yielded an association between schizophrenia and increased mortality from Covid-19 (RR 2.22; 95%CI: 1.54-3.20, p < 0.00001, I2 = 82% random-effect model). The increased risk of developing mortality from Covid-19 in patients with schizophrenia was significantly influenced by older age (p = 0.0004) and smoking (p = 0.0048).

Conclusions: This study proposes that patients with pre-existing schizophrenia are at risk of developing higher Covid-19 mortality. Patients with schizophrenia need special attention and should be prioritized to receive the SARS-CoV-2 vaccine.

Registration details: CRD42021293997.

Keywords: Coronavirus disease 2019; Covid-19; Psychiatry; Psychosis; Schizophrenia.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • COVID-19 Vaccines
  • COVID-19*
  • Humans
  • Quality of Life
  • SARS-CoV-2
  • Schizophrenia* / epidemiology

Substances

  • COVID-19 Vaccines