Mental Health and Substance Use Associated with Hospitalization among People with COVID-19: A Population-Based Cohort Study

Abstract

This study identified factors associated with hospital admission among people with laboratory-diagnosed COVID-19 cases in British Columbia. The study used data from the BC COVID-19 Cohort, which integrates data on all COVID-19 cases with data on hospitalizations, medical visits, emergency room visits, prescription drugs, chronic conditions and deaths. The analysis included all laboratory-diagnosed COVID-19 cases in British Columbia to 15 January 2021. We evaluated factors associated with hospital admission using multivariable Poisson regression analysis with robust error variance. Of the 56,874 COVID-19 cases included in the analysis, 2298 were hospitalized. Factors associated with increased hospitalization risk were as follows: male sex (adjusted risk ratio (aRR) = 1.27; 95% CI = 1.17–1.37), older age (p-trend < 0.0001 across age groups increasing hospitalization risk with increasing age [aRR 30–39 years = 3.06; 95% CI = 2.32–4.03, to aRR 80+ years = 43.68; 95% CI = 33.41–57.10 compared to 20–29 years-old]), asthma (aRR = 1.15; 95% CI = 1.04–1.26), cancer (aRR = 1.19; 95% CI = 1.09–1.29), chronic kidney disease (aRR = 1.32; 95% CI = 1.19–1.47), diabetes (treated without insulin aRR = 1.13; 95% CI = 1.03–1.25, requiring insulin aRR = 5.05; 95% CI = 4.43–5.76), hypertension (aRR = 1.19; 95% CI = 1.08–1.31), injection drug use (aRR = 2.51; 95% CI = 2.14–2.95), intellectual and developmental disabilities (aRR = 1.67; 95% CI = 1.05–2.66), problematic alcohol use (aRR = 1.63; 95% CI = 1.43–1.85), immunosuppression (aRR = 1.29; 95% CI = 1.09–1.53), and schizophrenia and psychotic disorders (aRR = 1.49; 95% CI = 1.23–1.82). In an analysis restricted to women of reproductive age, pregnancy (aRR = 2.69; 95% CI = 1.42–5.07) was associated with increased risk of hospital admission. Older age, male sex, substance use, intellectual and developmental disability, chronic comorbidities, and pregnancy increase the risk of COVID-19-related hospitalization.

COVID-19 Impact on Australian Patients with Substance Use Disorders: Emergency Department Admissions in Western Sydney before Vaccine Roll Out

“…A study from the USA showed that 53.2% of women used less alcohol during the pandemic compared to the pre-pandemic period, and only 24.2% used more alcohol than in the pre-pandemic period. A study using data on hospitalisations, medical visits, and emergency room visits from British Columbia showed that males (but not females) had increased risk of hospitalisation during the pandemic (adjusted risk ratio [aRR] 1.27 [95% CI: 1.17-1.37]), as did those with injection drug use (aRR 2.51 [2.14-2.95]), while women had lower risk of admission unless they were pregnant [30]. Another study from British Columbia showed, inter alia, female sex, Indigenous status, and phase of the pandemic have distinct effects on psychosocial outcomes, with women having more symptoms or more severe symptoms of depression, anxiety, loneliness, and stress than men, regardless of their age or ethnicity [31].…”

Effectiveness of COVID-19 vaccines against hospitalization and death in Canada: A multiprovincial test-negative design study

“…Information on the following covariates were obtained from relevant data sources [6][7][8]: age group, sex, geographic region (Supplemental Table S3), 2-week periods of test (to control for temporal changes in virus circulation and vaccine uptake), number of RT-PCR tests during the 3 months prior to the start of the study (as a proxy for frequently tested at-risk individuals), comorbidities that increase the risk of severe COVID-19 [9], receipt of 2019-2020 and/or 2020-2021 influenza vaccination (as a proxy for health behaviours), and 4 area-level social determinants of health (median neighbourhood income, proportion of the working population employed as non-health essential workers [i.e., those unable to work from home], average number of persons per dwelling, and proportion of the population who self-identify as a visible minority) [6]. All covariates were measured as of the start of the study period, except week of SARS-CoV-2 test.…”

A stakeholder-driven framework for measuring potential change in the health risks of people who inject drugs (PWID) during the COVID-19 pandemic

“…In addition to high risk for COVID-19 infection and related outcomes including hospitalization and death ( Allen et al, 2021 ; Atalla et al, 2021 ; Baillargeon et al, 2021 ; Centers for Disease Control and Prevention, 2021a ; Strathdee, Abramovitz, et al, 2021 ; Velasquez Garcia et al, 2021 ; Wang et al, 2021 ), other health risks among PWID have likely increased in the pandemic era ( Melamed et al, 2020 ; Walters et al, 2020 ). Health effects may include increased incidence and diminished management of HIV, hepatitis C virus (HCV), sexually transmitted infections (STI), and skin and soft tissue infections, as well as fatal and non-fatal overdose ( Gleason et al, 2021 ; Hoenigl et al, 2021 ; Mellis et al, 2021 ; Mistler et al, 2021 ; National Center for Health Statistics, 2021 ; Stanford et al, 2021 ; Strathdee, 2021 ; Walters et al, 2020 ; Zang et al, 2021 ; Zhang et al, 2021 ).…”