COVID-19 Mortality Rate in Patients with Mental Illness Up to 4 Times Higher Than General Population

Professor Hyejin Lee's Research Team at Bundang Seoul National University Hospital

A study has found that the mortality rate from COVID-19 among patients with mental illnesses is up to four times higher than that of the general population. Experts point out the need to develop response strategies to ensure that these individuals are not excluded from social safety nets in the event of future outbreaks of unknown infectious diseases.

The research team led by Professor Hyejin Lee from the Department of Family Medicine at Bundang Seoul National University Hospital (including Professor Jinyong Lee from Seoul National University Hospital Public Care Center and Professor Dongwook Lee from the Department of Occupational and Environmental Medicine at Inha University Hospital) conducted a study to identify the scale and extent of vulnerability to infectious diseases among patients with mental illnesses and to propose effective public health policies, announcing their findings on the 16th.

Professor Lee Hye-jin, Department of Family Medicine, Seoul National University Bundang Hospital; Professor Lee Jin-yong, Public Healthcare Center, Seoul National University Hospital; Professor Lee Dong-wook, Department of Occupational and Environmental Medicine, Inha University Hospital (from left).

The team utilized data from the Health Insurance Review and Assessment Service big data, including vaccination rates, COVID-19 incidence, and mortality rates for 3,961 general individuals and 11.53 million patients with mental illnesses. Mental illnesses were analyzed by categories: overall mental illnesses, mood disorders, and schizophrenia.

As a result, the probability of death from COVID-19 was found to be 1.71 times higher for patients with mental illnesses, 1.95 times higher for those with mood disorders, and 4.09 times higher for patients with schizophrenia compared to the general population. Conversely, the risk of COVID-19 infection was 1.06 times higher for patients with mental illnesses and 1.03 times higher for those with mood disorders compared to the general population, while it was actually lower for patients with schizophrenia at 0.92 times.

The research team analyzed that the higher mortality rate among patients with mental illnesses is due to a higher prevalence of conditions that increase the severity of COVID-19, such as smoking, diabetes, and cardiovascular diseases, compared to the general population, as well as a higher likelihood of reduced vaccine effectiveness or immune function. In particular, the very high mortality rate among patients with schizophrenia is attributed to a vaccination rate at about half the level of others and a healthcare system that makes hospitalization difficult even when their health deteriorates.

Professor Hyejin Lee emphasized, "The low vaccination rate among patients with schizophrenia is due to the weakening of face-to-face community mental health services during the COVID-19 period," adding, "Special attention must be paid to vulnerable groups for vaccination, such as patients with schizophrenia, during infectious disease outbreaks." Professor Dongwook Lee added, "Hospitals where patients with mental illnesses can be admitted are limited to psychiatric hospitals or care facilities, so there are insufficient medical resources for patients with mental illnesses," and stressed, "In future crisis situations such as global infectious disease outbreaks, response strategies must be established to ensure that people with mental illnesses are not excluded from social safety nets."

This study was published in the international academic journal Asian Journal of Psychiatry.

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