Risk of COVID-19 Hospitalization and Protection Associated With mRNA Vaccination Among US Adults With Psychiatric Disorders.
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Levy Matthew E, Yang Duck-Hye, Dunne Margaret M, Miley Kathleen, Irving Stephanie A, Grannis Shaun J, Weber Zachary A, Griggs Eric P, Spark Talia L, Bassett Elizabeth, Embi Peter J, Gaglani Manjusha, Natarajan Karthik, Valvi Nimish R, Ong Toan C, Naleway Allison L, Stenehjem Edward, Klein Nicola P, Link-Gelles Ruth, DeSilva Malini B, Kharbanda Anupam B, Raiyani Chandni, Beaton Maura A, Dixon Brian E, Rao Suchitra, Dascomb Kristin, Patel Palak, Mamawala Mufaddal, Han Jungmi, Fadel William F, Barron Michelle A, Grisel Nancy, Dickerson Monica, Liao I-Chia, Arndorfer Julie, Najdowski Morgan, Murthy Kempapura, Ray Caitlin, Tenforde Mark W, Ball Sarah W
Аннотация
METHODS: In a retrospective cohort analysis of the VISION Network in four US states, the rate of laboratory-confirmed COVID-19-associated hospitalization between December 2021 and August 2022 was compared across psychiatric diagnoses and by monovalent mRNA COVID-19 vaccination status using Cox proportional hazards regression.
RESULTS: Among 2,436,999 adults, 22.1% had ≥1 psychiatric disorder. The incidence of COVID-19-associated hospitalization was higher among patients with any versus no psychiatric disorder (394 vs. 156 per 100,000 person-years, p < 0.001). Any psychiatric disorder (adjusted hazard ratio [aHR], 1.27; 95% CI, 1.18-1.37) and mood (aHR, 1.25; 95% CI, 1.15-1.36), anxiety (aHR, 1.33, 95% CI, 1.22-1.45), and psychotic (aHR, 1.41; 95% CI, 1.14-1.74) disorders were each significant independent predictors of hospitalization. Among patients with any psychiatric disorder, aHRs for the association between vaccination and hospitalization were 0.35 (95% CI, 0.25-0.49) after a recent second dose, 0.08 (95% CI, 0.06-0.11) after a recent third dose, and 0.33 (95% CI, 0.17-0.66) after a recent fourth dose, compared to unvaccinated patients. Corresponding VE estimates were 65%, 92%, and 67%, respectively, and were similar among patients with no psychiatric disorder (68%, 92%, and 79%).
CONCLUSION: Psychiatric disorders were associated with increased risk of COVID-19-associated hospitalization. However, mRNA vaccination provided similar protection regardless of psychiatric disorder status, highlighting its benefit for individuals with psychiatric disorders.