Association of Psychiatric Disorders With Incidence of SARS-CoV-2 Breakthrough Infection Among Vaccinated Adults

Nishimi, Kristen; Neylan, Thomas C.; Bertenthal, Daniel; Seal, Karen H.; O’Donovan, Aoife

doi:10.1001/jamanetworkopen.2022.7287

Cited by 29 publications

(24 citation statements)

References 33 publications

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“…Currently, there are very few studies on mRNA vaccine efficacy in patients with SPI in treatment with psychotropic drugs. However, increased breakthrough infections and limited vaccine responses were reported by a recent epidemiological study on veterans with SPI, highlighting possible drug-vaccine interaction (Nishimi et al, 2022). This study is in line with earlier data, showing that, in general, patients with SPI exhibit suboptimal vaccine effectiveness, a phenomenon also documented in the geriatric population (Solomon et al, 1970;Hussar et al, 1971;Della Bella et al, 2007;Derhovanessian and Pawelec, 2012;Wang et al, 2016).…”

Section: Introductionsupporting

confidence: 89%

“…On the other hand, unlike older individuals, SPI patients display an increased number of natural killer cell (NKC) that are unaffected by the psychotropic drugs, probably explaining the low prevalence of malignancy as well as COVID-19 critical illness in this population (Yovel et al, 2000;Bao et al, 2021;Tarantino et al, 2021). Indeed, immune malfunction may account for both limited vaccine responses and protection from COVID-19 critical illness in medicated SPI patients (Nishimi et al, 2022), (Sfera et al, 2021;Nemani et al, 2022). For example, upregulated NKCs may promptly eliminate not only virus-infected but also mRNAtransfected cells, disrupting translation at the ribosomal level as well as antibody production (Arai et al, 1983;Brieva et al, 1984;Mason et al, 1988).…”

Section: Introductionmentioning

confidence: 99%

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Psychotropic drugs interaction with the lipid nanoparticle of COVID-19 mRNA therapeutics

et al. 2022

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The messenger RNA (mRNA) vaccines for COVID-19, Pfizer-BioNTech and Moderna, were authorized in the US on an emergency basis in December of 2020. The rapid distribution of these therapeutics around the country and the world led to millions of people being vaccinated in a short time span, an action that decreased hospitalization and death but also heightened the concerns about adverse effects and drug-vaccine interactions. The COVID-19 mRNA vaccines are of particular interest as they form the vanguard of a range of other mRNA therapeutics that are currently in the development pipeline, focusing both on infectious diseases as well as oncological applications. The Vaccine Adverse Event Reporting System (VAERS) has gained additional attention during the COVID-19 pandemic, specifically regarding the rollout of mRNA therapeutics. However, for VAERS, absence of a reporting platform for drug-vaccine interactions left these events poorly defined. For example, chemotherapy, anticonvulsants, and antimalarials were documented to interfere with the mRNA vaccines, but much less is known about the other drugs that could interact with these therapeutics, causing adverse events or decreased efficacy. In addition, SARS-CoV-2 exploitation of host cytochrome P450 enzymes, reported in COVID-19 critical illness, highlights viral interference with drug metabolism. For example, patients with severe psychiatric illness (SPI) in treatment with clozapine often displayed elevated drug levels, emphasizing drug-vaccine interaction.

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Section: Introductionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Psychotropic drugs interaction with the lipid nanoparticle of COVID-19 mRNA therapeutics

et al. 2022

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“…In contrast, a population based study of individuals who received two doses of ChAdOx1 ( n = 5770) or BNT162b2 ( n = 3331) failed to demonstrate a significant effect of depression/anxiety (considered as a single category) on the presence or absence of anti-spike protein antibodies [ 178 ]. Another study of over a quarter of a million individuals found that people with any psychiatric disorder were at an increased risk of a breakthrough COVID-19 following vaccination with an OR of 1.03–1.07 depending on the statistical model [ 179 ]. For MDD, the relative risk ranged from 1.05–1.11 but for both MDD and other psychiatric disorders, the effect was strongest in the participants aged 65 years or more even after controlling for medical comorbidity [ 179 ].…”

Section: Covid-19 Vaccine Response and Mental Healthmentioning

confidence: 99%

“…Another study of over a quarter of a million individuals found that people with any psychiatric disorder were at an increased risk of a breakthrough COVID-19 following vaccination with an OR of 1.03–1.07 depending on the statistical model [ 179 ]. For MDD, the relative risk ranged from 1.05–1.11 but for both MDD and other psychiatric disorders, the effect was strongest in the participants aged 65 years or more even after controlling for medical comorbidity [ 179 ]. As with COVID-19 pathology, exactly which pre-existing immune phenotypes predict vaccine immunogenicity or efficacy have not been fully investigated.…”

Section: Covid-19 Vaccine Response and Mental Healthmentioning

confidence: 99%

Depression, aging, and immunity: implications for COVID-19 vaccine immunogenicity

Ford

Savitz

2022

Immun Ageing

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The aging process can have detrimental effects on the immune system rendering the elderly more susceptible to infectious disease and less responsive to vaccination. Major depressive disorder (MDD) has been hypothesized to show characteristics of accelerated biological aging. This raises the possibility that depressed individuals will show some overlap with elderly populations with respect to their immune response to infection and vaccination. Here we provide an umbrella review of this literature in the context of the SARS CoV-2 pandemic. On balance, the available data do indeed suggest that depression is a risk factor for both adverse outcomes following COVID-19 infection and for reduced COVID-19 vaccine immunogenicity. We conclude that MDD (and other major psychiatric disorders) should be recognized as vulnerable populations that receive priority for vaccination along with other at-risk groups.

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“…10 Importantly, emerging studies suggested a diagnosis of psychiatric disorders increased risk factors for mortality in patients with COVID-19 and increased incidence of SARS-CoV-2 breakthrough infection after vaccination. 11,12 Evidence on the short-and longterm changes in psychiatric disorders is important to guide future targeted efforts on most at-risk populations.…”

Section: Introductionmentioning

confidence: 99%

Trends in Psychiatric Disorders by COVID-19 Infection and Hospitalization in 62 Counties in New York City from March 2020, to August 2021

Xiao

Sharma

Thiruvalluru

et al. 2022

Preprint

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Determining emerging trends of different psychiatric disorders among patients with SARS-CoV-2 infection and subsequent hospitalization by psychiatric disorder history is important to guide targeted public health priorities. This study used electronic health records among patients in New York derived from the largest health information exchange in the US and estimated the prevalence of psychiatric between March 2020 to August 2021. During the beginning of the COVID-19 pandemic, mood disorders were the most prevalent among hospitalized COVID-19 patients, whereas substance use disorders increased significantly among patients without prior psychiatric diseases. Mood disorders, anxiety disorders and psychosis increased by 488.0% (from 2.5–14.7%), 373.2% (from 2.6–12.3%) 232.4% (from 3.7–12.3%) from February to August 2021 among COVID-19 negative patients. This study is the first to address the differential trends in psychiatric disorders over COVID-19 pandemic. Tailored treatment and policies should be developed that account for psychiatry history.

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Association of Psychiatric Disorders With Incidence of SARS-CoV-2 Breakthrough Infection Among Vaccinated Adults

Cited by 29 publications

References 33 publications

Psychotropic drugs interaction with the lipid nanoparticle of COVID-19 mRNA therapeutics

Psychotropic drugs interaction with the lipid nanoparticle of COVID-19 mRNA therapeutics

Depression, aging, and immunity: implications for COVID-19 vaccine immunogenicity

Trends in Psychiatric Disorders by COVID-19 Infection and Hospitalization in 62 Counties in New York City from March 2020, to August 2021

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