A new study published in the Journal of
American Medical Association showed that postacute sequelae of
SARS-CoV-2 (PASC) were more common in patients with schizophrenia, bipolar
illness, or recurrent major depressive disorder, illuminating the necessity for
integrated mental health and COVID-19 care regimens.

It is uncertain if those with a
serious mental illness (SMI) are more likely to have postacute sequelae of
SARS-CoV-2 (PASC), given their greater susceptibility to COVID-19. Secondary
prevention initiatives might benefit from an understanding of this connection.
Thus, this study determined the risk that
individuals with a SMI will acquire PASC.

Data from extensive electronic
health records (EHRs) between March 2020 and April 2023, including a 180-day
follow-up, were used in this longitudinal cohort research. Adults 21 years of
age or older who had a proven COVID-19 infection as shown by a pertinent lab
test, diagnosis, or prescription order were considered patients. Evidence of a
diagnosis of schizophrenia, bipolar illness, or recurrent major depressive
disorder prior to COVID-19 infection.

Evidence of PASC symptoms within 30 to
180 days of follow-up following COVID-19 infection was considered the primary
outcome. It was given as odds ratios (OR) that were mutually adjusted for
race age, sex, and ethnicity, insurance type, COVID-19 severity and
Charlson Comorbidity Index (CCI) score.

1.    A
total of 1625 857 COVID-19-infected patients were included (mean [SD] age, 52
[17] years; 998 237 [61.4%] females, 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). 2.    Of
these, 258 523 (15.9%) had a SMI and 403 641 (24.8%) developed PASC). The
adjusted chances of developing PASC were higher in those with a SMI (OR, 1.10;
95% CI, 1.08-1.11; P <.001).

3.  Older
age compared to age 22 to 34 years, non-Hispanic Black and Hispanic race and
ethnicity compared to non-Hispanic White race and ethnicity (OR, 1.08; 95% CI,
1.07-1.10; OR, 1.12; 95% CI, 1.11-1.13), higher chronic disease burden when compared
to 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.

4.  Commercial
health insurance was linked to decreased chances of PASC when compared to
public insurance (OR, 0.85; 95% CI, 0.84-0.86). Overall, the necessity for coordinated
mental health and COVID-19 care methods is highlighted by the fact that
patients with SMI were more likely to develop PASC in this cohort analysis of
COVID-19-infected individuals than those without SMI.

Source:

Vekaria, V., Thiruvalluru, R. K., Verzani, Z., Abedian, S., Olfson, M., Patra, B. G., Xiao, Y., Salamon, K. S., Hoth, K., Blancero, F., Hornig-Rohan, M. M., Akintonwa, T., Sabiha, M., Weiner, M. G., Carton, T. W., Kaushal, R., Pathak, J., & RECOVER PCORnet EHR consortium. (2025). Schizophrenia, bipolar, or major depressive disorder and postacute sequelae of COVID-19. JAMA Network Open, 8(10), e2540242. https://doi.org/10.1001/jamanetworkopen.2025.40242