Impact of cannabis use, substance use disorders, and psychiatric diagnoses on COVID-19 outcomes

The Journal of Clinical PsychiatryScott Cunningham MD PhD, et al. | August 30, 2022

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Given the morbidity and mortality resulting from the COVID-19 pandemic, it is essential to identify patients at high risk for severe infections in an effort to implement preventive measures, including vaccinations, and assemble sufficient medical personnel, equipment, and supplies.

The current study provided convincing evidence that patients with COVID-19 and substance abuse and psychiatric disorders are a high-risk group.

A retrospective study was conducted involving patients with COVID-19 admitted to the hospital. Toxicology reports and medical records were reviewed to identify substance abuse and psychiatric disorders.

Patients with COVID-19 who were admitted to the hospital in 2020 (n=6291) and had a substance abuse disorder were more likely to require admission to the ICU (aOR=1.46) and need ventilatory support (aOR=1.49) than patients with COVID-19 without a substance abuse disorder. The former finding was in large part due to alcohol abuse disorder, while the latter finding was predominantly due to both alcohol and opioid use disorders.

These patients also had a longer hospital stay (11.32 vs. 8.62 days) and more hospital admissions during 2020 (2.96 vs. 2.33). The former finding was largely due to cocaine abuse disorder, while the latter finding was due to cannabis, alcohol, opioid, and benzodiazepine abuse disorders.

Patients with COVID-19 who were admitted to the hospital in 2020 and had a co-existing psychiatric disorder also had an increased length of hospital stay (11.93 vs. 8.39 days) and more hospital admissions in 2020 (2.72 vs. 2.31) than COVID-19 patients without a psychiatric disorder. Both of these findings were associated with schizophrenia and affective disorders.

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