Why do some people get sicker than others in a pandemic like Covid-19 is one of the most common queries. This inquiry has inspired experts to investigate some of the secrets of the human body, and they have come to some surprising discoveries as a result.
There were reports by psychiatrists in 2020 that people with psychiatric illnesses looked to be getting more severe types of Covid-19 at a higher rate than other high-risk populations. As a New York University neuropsychiatrist, Katlyn Nemani delved into the question: How much more at danger, and under what circumstances?
348 New York City Covid-19 patients were studied by her and her colleagues in a study published in January. Researchers found that people with schizophrenia spectrum disorders had a death rate from Covid-19 that was nearly 2.5 times higher than the average person’s, even after accounting for all of the other risk factors, including cardiovascular disease, diabetes, smoking, obesity, and race/gender/age demographics.
Nemani says, “That was a pretty shocking discovery.” She believes that because the patients were all hospitalized in the same medical system and in the same region, they weren’t receiving dramatically different treatments. Everything points to a direct link between mental illness and increased risk, and not to a random chance factor.
Since then, more research has been published, including meta-analyses that pool the findings of individual studies, demonstrating that persons with mental health diagnoses such as depression, bipolar disorder, and schizophrenia have worse Covid-19 outcomes.
Many persons with mental health difficulties have an elevated risk of poor health outcomes, so this isn’t surprising. A hypothesis that has been gaining support in recent years has been bolstered by the outbreak.
These illnesses appear to be linked to anything biological in the human body. Charles Raison, a psychiatrist and researcher at the University of Wisconsin Madison, believes there is a physiologic susceptibility in these people.
Covid-19 isn’t inherently more likely to infect people with mental health issues like schizophrenia or depression. When they become contaminated, “the effects are worse,” adds Nemani. “
The risk of dying from Covid-19 is 1.5 to 2 times higher for people with these disorders than the general population, after accounting for other risk factors, depending on the study and severity of the mental health diagnosis (unadjusted risk is even higher). When it comes to heart disease and diabetes, Nemani says, the increased risk is “on par with what we’re seeing.”
What’s going on here? Is there a connection between mental illness and an increased risk of developing respiratory disease?
Researchers in the field of psychiatry believe that a link between mental health and the immune system may be to blame for certain mental diseases. Mental health stressors may put patients at greater risk for infection, and they believe that the immune system’s response to these stressors may also play a role in some mental health problems.
Here, there’s a lot of mystery. These concerns are being examined in a fresh light thanks to the pandemic. In addition, the findings “might teach us something about how to protect these people from infection going forward,” says Nemani.
According to the Centers for Disease Control and Prevention, mood disorders like depression and bipolar disorder have been added to the list of underlying diseases that increase a person’s chance of developing severe Covid-19. Vaccines and booster doses are prioritized for this population because of the rising evidence published by Nemani and colleagues across medicine.
As one of the co-authors of one of two systematic reviews referenced by the CDC in its change, Roger McIntyre is an expert in mental health. On the other hand, Nemani is a co-author on the second. It’s not surprising to him that mental illness increases the danger of infection. McIntyre points out that “a common thread has been weaved through several of these illnesses is immunological or inflammatory dysfunction.
That is, mental health difficulties are often linked to immune system problems. SARS-CoV 2, the virus that produces Covid-19, can also worsen the outcomes of persons with immune system disorders.
According to him, “The vast majority of the time in medicine, there is no single explanation for anything.” People with mental health concerns may be more prone to serious illness, and this is especially true in this discussion. People with mental diseases such as schizophrenia, bipolar disorder, and significant depression have shorter life spans and worse overall health than the general population. Heart disease and obesity are more common, and smoking is more prevalent as well. People with mental health difficulties, particularly schizophrenia, are at greater risk of death from a wide range of causes, including serious infections, as a result of these risk factors.
It’s impossible to control for all of these things in the research that have been done so far. Economic hardship, increased isolation due to a pandemic, diagnostic testing availability or individual behaviors that are difficult to control for in research may have a part in the pandemic’s spread.
However, the scientific literature shows that mental health and immune system health are linked. Inflammation has been linked to a wide range of mental health concerns, including depression, bipolar disorder, schizophrenia, and additional conditions not included in the CDC’s Covid-19 risk factors.
When the body encounters a threat like the SARS-CoV-2 virus, it responds by inflaming itself. Fluids carrying immune system cells flood the body during inflammation. To aid in the healing of infections, they are excreted from the blood into the tissues of the body. Swelling is a sign that a region of the body is infected.
Inflammation that subsides quickly can aid in the removal of infection. When it’s a long-term condition, it can be dangerous. It has a negative impact on the heart and can lead to conditions such as diabetes. According to scientists, some patients’ systems overreact to the Covid-19 virus because of an underlying inflammation or immune system dysregulation, leading to the most severe symptoms that can place them in the hospital and even lead to death.
Inflammation rises in correlation with the severity of the mental disease, as Nemani explains. Systemic inflammation rises in patients with depression, according to Nemani. Those suffering from severe depression, bipolar disorder, and schizophrenia have an increased risk of developing the condition. On a continuum, there are various degrees of severity for each of these disorders.
Covid-19 might not work as well for persons who have persistent inflammation as a result of mental health difficulties. The first question to ask is, “Why are they suffering from chronic inflammation?”
According to McIntyre and Nemani, prolonged stress from dealing with mental health difficulties could be a contributing factor. Stress and sleep deprivation can both cause an inflammatory reaction.
However, the immune system may also be a factor in the development of many disorders. It wasn’t until the year 2000 that Raison and his colleagues began to discover that inflammation might lead to depression. According to this research, “the best evidence is that there have been several studies where people have been given inflammatory stimuli of various intensities and durations [such as drugs known to cause inflammation].”
According to McIntyre, scientists frequently (but not always) discover higher levels of inflammation in the blood of people who are suffering from depression. “Now, it may not be the causative role, although it might be,” he claims. “It may be the primary factor in some cases, but it may also be a contributing factor in others.”
This raises even another question: Why would the immune system affect our mood and exhaustion?..?
McIntyre uses the common cold as an example to illustrate his point. If you have a cold, I’m not suggesting you’re depressed, but you’re showing many of the same symptoms as someone who is depressed, he adds.” A lack of energy and a lack of appetite are the most common symptoms of this condition. Most likely, you’re not having fun doing anything. Apathetic is an understatement. Your life has become drab. These symptoms are being caused by an overactive immune system. That may explain your depressive symptoms for certain persons with depression, according to our theory.”
Depressive symptoms might be exacerbated or even generated when your immune system isn’t functioning properly.
It’s also probable that the immune system contributes to the development of schizophrenia. It has been suggested that prenatal virus exposure may increase the risk of developing schizophrenia or other psychotic disorders later in life. This notion has been advanced by Dr. Ellen Lee, a UC San Diego psychiatrist and schizophrenia researcher. An illness in the mother may have an impact on the child’s brain and immune system later in life. Having a past autoimmune condition has been linked to an increased chance of developing schizophrenia, according to other research. There’s still a lot we don’t know, as Lee points out.
The most important thing, according to Lee, is to understand that schizophrenia is “a disorder of the whole body.” “We see an increase in brain inflammation and an increase in inflammation across the board.” Those who suffer from schizophrenia are at greater risk of developing any number of long-term health problems. Fat storage and inflammation are two interrelated problems, according to Lee’s research. There’s a lot of repetition in this story.