Image of older man with cane, sitting alone

Fully vaccinated COVID-19 survivors with a history of certain psychiatric disorders may be pre-disposed to reinfection, researchers from the San Francisco Veterans Affairs (VA) Health Care System and the University of California assert in a new study of more than a quarter of a million U.S. veterans.

Researchers analyzed the administrative and electronic health records of veterans who completed their COVID-19 vaccine primary series at least 14 days earlier from Feb 20, 2020, to Nov 16, 2021. Patients had received the Pfizer/BioNTech, Moderna or Johnson & Johnson vaccine.

Those psychiatric disorders elevating the risk of COVID-19 reinfection included depression, post-traumatic stress, anxiety, adjustment disorder, substance use disorder, bipolar disorder, psychosis, attention-deficit hyperactivity disorder, dissociation and eating disorders within the past five years. Psychiatric disorders were more common in patients younger than 65 than in their older peers.

The risk of COVID-19 reinfection was 24% higher for patients 65 and older with substance abuse, 23% higher for those with psychotic disorders, 16% for bipolar disorder, 14% for adjustment disorder and 12% for anxiety. Other recipients more prone to reinfection included patients with chronic kidney disease (23%), along with HIV (20%), cardiovascular disease (19%), chronic obstructive pulmonary disease (COPD) (18%) and sleep apnea (13%).

This indicates that older patients with certain psychiatric conditions face risks on par with those of other medical conditions, noted senior author Aoife O’Donovan, Ph.D., of the San Francisco VA.

“Mental health is important to consider in conjunction with other risk factors,” she said in a prepared statement.

Meanwhile, researchers pointed out that psychiatric conditions may be a risk factor for an increased incidence of breakthrough infection independent of certain other factors.

“Our findings indicate that individuals with psychiatric disorders … should be prioritized for booster vaccinations and other critical preventive efforts, including increased SARS-CoV-2 screening, public health campaigns or COVID-19 discussions during clinical care,” they said.

The study was published April 14 in JAMA Network Open. The Center for Infectious Disease Research and Policy reported on the study.