Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999) · 2025
Vaccine protection against COVID-19-related mortality in patients with schizophrenia: a retrospective cohort study.
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Oliveira Fabrício E S, Martelli-Júnior Hercílio, Colosimo Enrico A, Silva Ana Cristina Simões E, Dias Cristiane S, Diniz Lilian O, Pinhati Clara C, Galante Stella C, Duelis Fernanda N, Carvalho Laura E, Martell Daniella R B, Mak Robert H, Oliveira Maria Christina L, Oliveira Eduardo A
Аннотация
OBJECTIVE: This study analyzed the role of vaccination in preventing COVID-19-related mortality in patients with schizophrenia.
METHODS: This retrospective cohort study analyzed data from the Influenza Epidemiological Surveillance Information System (Sistema de Informação da Vigilância Epidemiológica da Gripe [SIVEP-Gripe]) database, focusing on patients aged = 18 years with laboratory-confirmed COVID-19 between February 2020 and February 2023. The primary exposure was schizophrenia. The primary outcome of interest was the role of vaccines in preventing COVID-19-associated mortality. Statistical analysis included multiple binary logistic regressions to determine the impact of schizophrenia on mortality and to compare vaccine protection between cohorts.
RESULTS: The cohort included 2,131,089 patients, 3,516 (0.2%) of whom had schizophrenia. After adjusting for potential confounders, patients with schizophrenia presented a significantly higher risk of severe disease (OR = 1.59, 95%CI 1.39-1.81) and mortality (OR = 1.65, 95%CI 1.45-1.87). After the booster dose, protection against mortality was estimated at 67.7% (95%CI 66.5-68.7) in the non-schizophrenia cohort and 62.4% (95%CI 44.1-74.6) in the schizophrenia cohort. Mortality rate differences of approximately 20% and 10% were observed between boosted and non-vaccinated individuals among the schizophrenia and non-schizophrenia cohorts, respectively. Consequently, five patients (95%CI 4-8) with schizophrenia and 10 patients (95%CI 9-11) in the general population would need to receive a booster dose to prevent one fatality.
CONCLUSIONS: Our results suggest that vaccination provided similar protection against COVID-19-related mortality in individuals with and without schizophrenia. However, the magnitude of the intervention effect was double for individuals with schizophrenia due to their higher baseline risk.
METHODS: This retrospective cohort study analyzed data from the Influenza Epidemiological Surveillance Information System (Sistema de Informação da Vigilância Epidemiológica da Gripe [SIVEP-Gripe]) database, focusing on patients aged = 18 years with laboratory-confirmed COVID-19 between February 2020 and February 2023. The primary exposure was schizophrenia. The primary outcome of interest was the role of vaccines in preventing COVID-19-associated mortality. Statistical analysis included multiple binary logistic regressions to determine the impact of schizophrenia on mortality and to compare vaccine protection between cohorts.
RESULTS: The cohort included 2,131,089 patients, 3,516 (0.2%) of whom had schizophrenia. After adjusting for potential confounders, patients with schizophrenia presented a significantly higher risk of severe disease (OR = 1.59, 95%CI 1.39-1.81) and mortality (OR = 1.65, 95%CI 1.45-1.87). After the booster dose, protection against mortality was estimated at 67.7% (95%CI 66.5-68.7) in the non-schizophrenia cohort and 62.4% (95%CI 44.1-74.6) in the schizophrenia cohort. Mortality rate differences of approximately 20% and 10% were observed between boosted and non-vaccinated individuals among the schizophrenia and non-schizophrenia cohorts, respectively. Consequently, five patients (95%CI 4-8) with schizophrenia and 10 patients (95%CI 9-11) in the general population would need to receive a booster dose to prevent one fatality.
CONCLUSIONS: Our results suggest that vaccination provided similar protection against COVID-19-related mortality in individuals with and without schizophrenia. However, the magnitude of the intervention effect was double for individuals with schizophrenia due to their higher baseline risk.