Schizophrenia, Bipolar, or Major Depressive Disorder and Postacute Sequelae of COVID-19

Veer Vekaria; Rohith Kumar Thiruvalluru; Zoe Verzani; Sajjad Abedian; Mark Olfson; Braja Gopal Patra; Yunyu Xiao; Katherine S Salamon; Karin Hoth; Frank Blancero; Maxwell M Hornig-Rohan; Teresa Akintonwa; Mahfuza Sabiha; Mark G Weiner; Thomas W Carton; Rainu Kaushal; Jyotishman Pathak; RECOVER PCORnet EHR consortium

doi:10.1001/jamanetworkopen.2025.40242

Back

Schizophrenia, Bipolar, or Major Depressive Disorder and Postacute Sequelae of COVID-19

Journal article

Open access

Peer reviewed

Schizophrenia, Bipolar, or Major Depressive Disorder and Postacute Sequelae of COVID-19

Veer Vekaria, Rohith Kumar Thiruvalluru, Zoe Verzani, Sajjad Abedian, Mark Olfson, Braja Gopal Patra, Yunyu Xiao, Katherine S Salamon, Karin Hoth, Frank Blancero, …

JAMA network open, Vol.8(10), e2540242

10/01/2025

DOI: 10.1001/jamanetworkopen.2025.40242

PMCID: PMC12573031

PMID: 41160025

Files and links (1)

url

https://doi.org/10.1001/jamanetworkopen.2025.40242View

Published (Version of record) Open Access

Abstract

Importance Given the increased vulnerability to COVID-19 among those with a serious mental illness (SMI), it remains unclear whether these individuals face a higher risk of developing postacute sequelae of SARS-CoV-2 (PASC). Understanding this association could inform secondary prevention efforts. Objective To identify the risk of developing PASC in patients with an SMI. Design, Setting, and Participants This longitudinal cohort study used data derived from large-scale electronic health records (EHRs) between March 2020 and April 2023, inclusive of 180-day follow-up. Patients included adults aged 21 years or older with a confirmed COVID-19 infection evidenced by a relevant laboratory result, diagnosis, or prescription order. Exposures Evidence of an SMI diagnosis (schizophrenia, bipolar disorder, or recurrent major depressive disorder) recorded before COVID-19 infection. Main Outcomes and Measures Evidence of PASC symptoms within 30 to 180 days’ follow-up after COVID-19 infection reported as odds ratios (OR) mutually adjusted for age, sex, race and ethnicity, insurance type, Charlson Comorbidity Index (CCI) score, and COVID-19 severity. Results A total of 1 625 857 patients with a COVID-19 infection were included (mean [SD] age, 52 [17] years; 998 237 [61.4%] female, 204 237 [12.6%] non-Hispanic Black, 219 220 [13.5%] Hispanic, 833 411 [51.3%] non-Hispanic White, and 1 228 664 [75.6%] urban patients), of whom 258 523 (15.9%) had an SMI and 403 641 (24.8%) developed PASC. Individuals with an SMI had increased adjusted odds of developing PASC (OR, 1.10; 95% CI, 1.08-1.11; P < .001). Variables associated with greater odds of PASC among the study population included older age compared with age 22 to 34 years (35 to 44 years: OR, 1.04; 95% CI, 1.03-1.06; 45 to 64 years: OR, 1.11; 95% CI, 1.10-1.12; ≥65 years: OR, 1.18; 95% CI, 1.17-1.20), non-Hispanic Black and Hispanic compared with non-Hispanic White race and ethnicity (non-Hispanic Black: OR, 1.08; 95% CI, 1.07-1.10; Hispanic: OR, 1.12; 95% CI, 1.11-1.13), higher chronic disease burden vs no chronic disease (CCI 1 to 3: OR, 1.13; 95% CI, 1.12-1.14; CCI ≥4: OR, 1.23; 95% CI, 1.22-1.25), and hospitalization with initial COVID-19 infection vs no hospitalization (hospitalized: OR, 1.80; 95% CI, 1.77-1.82; hospitalized with ventilation: OR, 2.17; 95% CI, 2.12-2.22; P < .001). Compared with public insurance, commercial health insurance was associated with lower odds of PASC (OR, 0.85; 95% CI, 0.84-0.86). Conclusions and Relevance In this cohort study of patients infected with COVID-19, patients with SMI compared with those without SMI were at increased risk of PASC, underscoring the need for coordinated mental health and COVID-19 care strategies.

Comorbidity

Adult

Aged

Bipolar Disorder - complications

Bipolar Disorder - epidemiology

COVID-19 - complications

COVID-19 - epidemiology

COVID-19 - psychology

Depressive Disorder, Major - complications

Depressive Disorder, Major - epidemiology

Female

Humans

Longitudinal Studies

Male

Middle Aged

Post-Acute COVID-19 Syndrome

Risk Factors

SARS-CoV-2

Schizophrenia - complications

Schizophrenia - epidemiology

Details

Title: Subtitle: Schizophrenia, Bipolar, or Major Depressive Disorder and Postacute Sequelae of COVID-19
Creators: Veer Vekaria - Cornell University
Rohith Kumar Thiruvalluru - Cornell University
Zoe Verzani - Weill Cornell Medicine
Sajjad Abedian - Cornell University
Mark Olfson - Columbia University
Braja Gopal Patra - Cornell University
Yunyu Xiao - Cornell University
Katherine S Salamon - Nemours Children's Health System
Karin Hoth - University of Iowa
Frank Blancero - RECOVER Patient, Caregiver, or Community Advocate Representative, New York, New York
Maxwell M Hornig-Rohan - RECOVER Patient, Caregiver, or Community Advocate Representative, New York, New York
Teresa Akintonwa - RECOVER Patient, Caregiver, or Community Advocate Representative, New York, New York
Mahfuza Sabiha - Cornell University
Mark G Weiner - Weill Cornell Medicine
Thomas W Carton - Louisiana Public Health Institute
Rainu Kaushal - Cornell University
Jyotishman Pathak - Cornell University
RECOVER PCORnet EHR consortium
Resource Type: Journal article
Publication Details: JAMA network open, Vol.8(10), e2540242
DOI: 10.1001/jamanetworkopen.2025.40242
PMID: 41160025
PMCID: PMC12573031
NLM abbreviation: JAMA Netw Open
ISSN: 2574-3805
eISSN: 2574-3805
Publisher: AMER MEDICAL ASSOC
Grant note: NIH Researching COVID to Enhance Recovery (RECOVER EHR) Initiative - NIH Agreement OTA: OT2HL161847
This study is part of the NIH Researching COVID to Enhance Recovery (RECOVER EHR) Initiative, which seeks to understand, treat, and prevent the postacute sequelae of SARS-CoV-2 infection. This research was funded by the NIH Agreement OTA OT2HL161847 as part of the RECOVER research program.
Language: English
Date published: 10/01/2025
Academic Unit: Psychiatry; Iowa Neuroscience Institute
Record Identifier: 9985019044502771

Metrics

5 Record Views

See more details