Vitamin D deficiency in schizophrenia implications for COVID-19 infection

Viani-Walsh, Dylan; Kennedy-Williams, Saran; Taylor, David; Gaughran, Fiona; Lally, John

doi:10.1017/ipm.2020.107

Cited by 6 publications

(8 citation statements)

References 70 publications

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“…Patients with SMI often have lower vitamin D levels (146). Several meta-analyses (147,148) and publications (146,(149)(150)(151)(152)(153) suggest that vitamin D supplementation may be potentially effective in preventing COVID-19 infection and mitigating the clinical course of the disease. Study results, however, remain difficult to interpret due to possible confounding factors (149,154).…”

Section: Prevention Strategies and Possible Therapeutic Optionsmentioning

confidence: 99%

COVID-19-Related Mortality Risk in People With Severe Mental Illness: A Systematic and Critical Review

et al. 2022

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Background: Increasing clinical evidence suggests that people with severe mental illness (SMI), including schizophrenia spectrum disorders, bipolar disorder (BD), and major depressive disorder (MDD), are at higher risk of dying from COVID-19. Several systematic reviews examining the association between psychiatric disorders and COVID-19-related mortality have recently been published. Although these reviews have been conducted thoroughly, certain methodological limitations may hinder the accuracy of their research findings.Methods: A systematic literature search, using the PubMed, Embase, Web of Science, and Scopus databases (from inception to July 23, 2021), was conducted for observational studies assessing the risk of death associated with COVID-19 infection in adult patients with pre-existing schizophrenia spectrum disorders, BD, or MDD. Methodological quality of the included studies was assessed using the Newcastle-Ottawa Scale (NOS).Results: Of 1,446 records screened, 13 articles investigating the rates of death in patients with pre-existing SMI were included in this systematic review. Quality assessment scores of the included studies ranged from moderate to high. Most results seem to indicate that patients with SMI, particularly patients with schizophrenia spectrum disorders, are at significantly higher risk of COVID-19-related mortality, as compared to patients without SMI. However, the extent of the variation in COVID-19-related mortality rates between studies including people with schizophrenia spectrum disorders was large because of a low level of precision of the estimated mortality outcome(s) in certain studies. Most studies on MDD and BD did not include specific information on the mood state or disease severity of patients. Due to a lack of data, it remains unknown to what extent patients with BD are at increased risk of COVID-19-related mortality. A variety of factors are likely to contribute to the increased mortality risk of COVID-19 in these patients. These include male sex, older age, somatic comorbidities (particularly cardiovascular diseases), as well as disease-specific characteristics.Conclusion: Methodological limitations hamper the accuracy of COVID-19-related mortality estimates for the main categories of SMIs. Nevertheless, evidence suggests that SMI is associated with excess COVID-19 mortality. Policy makers therefore must consider these vulnerable individuals as a high-risk group that should be given particular attention. This means that targeted interventions to maximize vaccination uptake among these patients are required to address the higher burden of COVID-19 infection in this already disadvantaged group.

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Section: Prevention Strategies and Possible Therapeutic Optionsmentioning

confidence: 99%

COVID-19-Related Mortality Risk in People With Severe Mental Illness: A Systematic and Critical Review

et al. 2022

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“…A recent study reported that schizophrenia patients under 55 years, who were predominantly obese had 14% higher risk for more ICU admissions than controls (13). Furthermore, individuals with obesity and schizophrenia have lower vitamin D concentrations, which could also impair immune response (80,81). There is mounting evidence that vitamin D deficiency could be a risk factor for adverse COVID-19 outcomes (81), and the efficacy of vitamin D supplementation in reducing risk and/or severity of COVID-19 is currently being investigated in randomised controlled trials.…”

Section: Obesitymentioning

confidence: 99%

COVID-19 in People With Schizophrenia: Potential Mechanisms Linking Schizophrenia to Poor Prognosis

et al. 2021

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As the global burden of mortality from COVID-19 continues to rise, an understanding of who is most at risk of adverse outcomes is of paramount importance. Pre-existing cardiometabolic, renal and respiratory diseases as well as old age are well-established risk factors associated with disease severity and mortality among patients with COVID-19. However, mounting evidence also indicates an increased susceptibility to, and risk of adverse outcomes from COVID-19 in people with schizophrenia, independent of age and comorbidity. Therefore, elucidating the underlying pathophysiological mechanisms which may increase the risk of poor outcomes in people with schizophrenia is of crucial importance. Here, we provide a narrative on the current understanding of COVID-19 in patients with schizophrenia and propose potential mechanisms which may link schizophrenia with an increased susceptibility to, and greater risk of adverse outcomes from COVID-19. Given the existing knowledge gaps, robust clinical and biological studies are required to further our understanding of some of these underlying mechanisms, so that effective prevention and treatment strategies for COVID-19 in patients with schizophrenia can be developed.

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“…One Swedish study of patients with bipolar disorder estimated that 26% patients treated with lithium had hypercalcaemia, compared with 1.5% not Vitamin D and serious mental disorders VIT-D deficiency has been linked to several severe mental and neurodevelopmental disorders, including depression and schizophrenia, autism and ADHD. [68][69][70] However, it remains unclear whether the link between VIT-D deficiency and such disorders is causal or just associative.…”

Section: Factors Associated With Vit-d Deficiencymentioning

confidence: 99%

“…VIT-D deficiency has been linked to several severe mental and neurodevelopmental disorders, including depression and schizophrenia, autism and ADHD. 68–70 However, it remains unclear whether the link between VIT-D deficiency and such disorders is causal or just associative.…”

Section: Vitamin D and Serious Mental Disordersmentioning

confidence: 99%

Vitamin D in the time of the coronavirus (COVID-19) pandemic – a clinical review from a public health and public mental health perspective

Werneke

Gaughran

Taylor

2021

Therapeutic Advances in Psychopharmacology

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Individuals with serious mental disorders (SMD) may have a higher risk of vitamin D (VIT-D) deficiency. They also experience higher mortality because of coronavirus disease 2019 (COVID-19) infection. Therefore, we have conducted a comprehensive review to examine the significance of VIT-D for public health and public mental health during the ongoing COVID-19 pandemic. This review had three specific aims, from a global perspective to (a) create a profile of VIT-D and review the epidemiology of VIT-D deficiency, (b) explore VIT-D deficiency as risk factor for SMD and COVID-19 infections and (c) examine the effectiveness of VIT-D supplementation for both conditions. We found that, in terms of SMD, the evidence from laboratory and observational studies points towards some association between VIT-D deficiency and depression or schizophrenia. Mendelian randomisation studies, however, suggest no, or reverse, causality. The evidence from intervention studies is conflicting. Concerning COVID-19 infection, on proof of principle, VIT-D could provide a plausible defence against the infection itself and against an adverse clinical course. But data from observational studies and the first preliminary intervention studies remain conflicting, with stronger evidence that VIT-D may mitigate the clinical course of COVID-19 infection rather than the risk of infection in the first place. From a public health and public mental health point of view, based on the currently limited knowledge, for individuals with SMD, the benefits of VIT-D optimisation through supplementation seem to outweigh the risks. VIT-D supplementation, however, should not substitute for vaccination or medical care for COVID-19 infection.

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Vitamin D deficiency in schizophrenia implications for COVID-19 infection

Cited by 6 publications

References 70 publications

COVID-19-Related Mortality Risk in People With Severe Mental Illness: A Systematic and Critical Review

COVID-19-Related Mortality Risk in People With Severe Mental Illness: A Systematic and Critical Review

COVID-19 in People With Schizophrenia: Potential Mechanisms Linking Schizophrenia to Poor Prognosis

Vitamin D in the time of the coronavirus (COVID-19) pandemic – a clinical review from a public health and public mental health perspective

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