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We all know by now that COVID-19 doesn’t affect every population group equally, and most of us know that age is the most common risk factor. The older a person is, the more likely they are not only to catch the virus but also to suffer severe adverse effects from it.
But the second-biggest risk factor isn’t so obvious. It isn’t diabetes, obesity, smoking, or anything else that’s received major coverage in the news. It’s schizophrenia.
Researchers from several countries have conducted studies on schizophrenia and COVID-19, controlling for risk factors such as age, weight, and other health conditions, and all reached the same conclusion: The risk of COVID-19 death is several times higher for a person with schizophrenia than for someone without it.
Understanding Schizophrenia
Schizophrenia is a mental illness that affects the way a person perceives reality and interacts with the outside world. Many people still believe that schizophrenia involves multiple personalities, thanks in large part to a few bad jokes that made their way around in decades past (e.g., “I used to be schizophrenic, but now we’re OK”).
But that characterization is completely false — the term for multiple personalities is dissociative identity disorder. A person with schizophrenia doesn’t have different personalities but rather struggles to separate what’s inside their head from what’s real.
With a 1% occurrence rate worldwide, schizophrenia might not sound common, but that means more than 3 million people in the United States have the condition. Experts are split on precisely what causes it, but most agree it results from a combination of genetic and environmental factors.
Common environmental factors that increase the risk of developing schizophrenia include poverty, neglect, childhood trauma, and urban living. Interestingly, though many of these risk factors occur during childhood, the condition doesn’t usually manifest until late adolescence in males and early to mid-20s in females.
It’s not always easy to tell that a person has schizophrenia, but some of the telltale signs include delusions, hallucinations, disorganized speech, paranoia, and flattened affect, meaning a limited emotional range.
Movies and TV shows — when they’re not falsely pushing the idea of multiple personalities — often portray schizophrenics as loud, belligerent, scary people who have heated arguments with lampposts and toaster ovens. But the reality can be much more subtle, and the condition often sets in slowly.
If you have a friend or loved one who seems to be slowly losing their grip on reality, it might be a good idea to speak with a mental health professional on their behalf. A tactful intervention not only helps them get the mental health treatment they need, but it might also cut their risk of dying from Covid.
Understanding the Relevant Factors of Covid
A multitude of factors determines a person’s risk of dying from Covid. While some of these factors are obvious — age, weight, tobacco use, preexisting health conditions — others are seemingly random.
By this point, we all know many people who’ve had COVID-19, and if the data is correct, between two-thirds and three-fourths of us have had it ourselves. Sadly, most of us know at least one person who’s died from the virus, and probably several more who’ve gotten extremely ill, perhaps requiring hospitalization.
We’ve also probably been surprised at some point by an elderly or unhealthy friend or family member who shook off the virus with relative ease. And we’ve likely been equally vexed when someone young and athletic struggled for weeks or months with it.
While scientists still can’t pinpoint the exact reason for the apparent randomness with which COVID-19 exerts its worst effects, most of the evidence suggests it has to do with the unique makeup of each person’s immune system and how it elicits and mobilizes antibodies to fight the virus.
That means conditions that negatively impact the immune system, whether inherited or developed, are the ones most likely to increase a person’s risk of developing severe COVID-19, even if the connection between the condition itself and the immune system isn’t obvious.
Why Schizophrenia Is a Significant Risk Factor
What the studies strongly suggest is that schizophrenia is a major risk factor for COVID-19 because of the way it negatively impacts the immune system.
How do we know this? The studies on COVID-19 and schizophrenia controlled for other factors like poor health and limited access to health care that might make a person with the condition more likely to die from COVID-19.
The study participants all had access to the same doctors in the same healthcare systems and were tested and treated at the same intervals. They were screened for other preexisting health conditions, and the results were factored into the studies.
Schizophrenia was the only remaining variable that differentiated those with elevated COVID mortality rates from those with normal rates. This points to something deeper going on, something involving the way the body responds to threats and changes to its environment.
Moreover, the impact of schizophrenia on the immune system might also be what drives many of the condition’s most salient effects on the brain and body: hallucinations, delusions, voices in the head, and so forth.
Further research into the Covid-schizophrenia link and the degree to which the immune system plays a role will not only help the medical community protect this vulnerable population from Covid, it could also lead to advancements in the treatment of the condition itself.
How This Can Help Us Improve Care
A diagnosis of schizophrenia can be devastating if it happens to you or a loved one, but thanks to the research on schizophrenia and COVID-19, new doors to promising treatments are being opened.
Antipsychotic drugs represent the most common treatment for schizophrenia at present, but they have limited efficacy and a host of undesirable side effects. What if there were instead a way to address the condition at the root of the problem using immunological treatments?
This is the avenue researchers are currently taking, and their sense of urgency is growing as public awareness of our country’s mental health crisis deepens by the week.
At FHE Health, we understand the struggle of living with schizophrenia, especially in the era of Covid. If you or a loved one has recently been diagnosed, contact us at FHE to find out more about how we can help. Our mental health professionals can connect you with the latest treatments and set you on a path to a happier, healthier life. Call (833) 596-3502 to speak with a team member today.
