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Bipolar, PTSD patients more likely to die from Covid, UCSF researchers find

Health care professional Gabriel Malan prepares Covid and MPX vaccines at a vaccination and testing site located on the corner of 24th Street and Capp Street in San Francisco on Oct. 14, 2022. | Benjamin Fanjoy/The Standard

People with psychiatric conditions like post-traumatic stress disorder and bipolar disorder may be more likely to be hospitalized or die from Covid, according to a study published Tuesday by researchers at the University of California San Francisco.

The study, which was published in the medical journal Translational Psychiatry, found that the risk of being hospitalized for at least 60 days with Covid rose 9% and risk of death rose 8% for those with PTSD, when adjusting for age, sex, race and underlying medical conditions.

Likewise, people with bipolar disorder had a 29% higher chance of dying from Covid and a 46% higher chance of being hospitalized, while the risk of death rose 13% and hospitalization 21% among people with major depression.

The researchers examined the association between psychiatric disorders and serious cases of Covid among roughly 228,000 patients in the U.S. Department of Veterans Affairs health care system who had tested positive between February 2020 and August 2021.

“Psychological stress from the pandemic overall, or the experience of SARS-CoV-2 infection itself, may have exacerbated psychiatric symptoms, which could affect inflammatory response,” said Aoife O’Donovan, an associate professor of psychiatry at UCSF and a senior author of the study.

“Additionally, PTSD may accelerate cellular aging, shortening telomeres, thus increasing the risk of age-associated diseases,” O'Donovan said.

People walk through San Francisco General Hospital where five medical personnel were vaccinated for Covid on Dec. 15, 2020. | Gabrielle Lurie /The San Francisco Chronicle via Getty Images

Among those sampled in the study, 25.6 had been diagnosed with PTSD within the prior five years, 28.2% with another psychiatric disorder and 46.2% did not have a psychiatric disorder.

The average age of those in the study was 60.6 years old, 89.5% were men and 72.1% had at least one other medical condition, including obesity, diabetes and heart disease.

The study found that patients with a psychiatric disorder had a higher risk of dying from Covid than those without one when adjusting only for age, sex, race and ethnicity, while not accounting for underlying medical conditions.

According to the researchers, that is consistent with previous studies suggesting the combination of unhealthy activities like poor diet, smoking and a lack of physical activity in combination with underlying health conditions is more likely to result in serious illness and death.

Those with psychiatric disorders may also suffer from higher levels of inflammation and an improperly functioning immune system, according to O’Donovan.

“PTSD, in particular, is characterized by lower levels of the stress hormone cortisol, which has anti-inflammatory properties that may be beneficial in reducing the inflammatory activity that underlies many adverse outcomes of Covid,” she said.

The study was conducted by researchers at UCSF’s Department of Psychiatry and Behavioral Sciences and the Mental health Service at the San Francisco VA Health Care System.

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