Severe mental illness linked to 50% increase in COVID-related death

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People with severe mental illness (SMI) are at a 50% increased risk of death from all causes following COVID-19 infections, according to a study today in The British Journal of Psychiatry.

The study was based on outcomes seen among 660,000 UK patients from February 2020 to April 2021, including 7,146 people with severe mental illness, such as schizophrenia, bipolar disorder, and psychosis. The authors compared outcomes between cases—those with SMIs—and controls, those without. All data came from the Clinical Practice Research Database, which contains more than 60 million anonymized electronic primary care records.

Following COVID-19 infection, the SMI group experienced a greater risk of death compared with controls (adjusted hazard ratio, 1.53; 95% confidence interval, 1.39 to 1.68).

"Patients with an SMI were older than controls," the authors said. "A higher proportion of patients with an SMI who contracted COVID-19 were obese, current smokers and of Black Caribbean/Black African ethnicity, compared with the other groups, and had multimorbidity."

Authors recommend vaccination

Black people were at a 22% higher risk of death following COVID-19 infection than White people, regardless of SMI diagnosis or lack of diagnosis. In addition, while all-cause mortality decreased after the first wave of COVID-19 infections in the country (February to September 2020) for controls, rates remained steady for those with SMI.

These are stark findings.

"These are stark findings and highlight the health inequalities that exist for people living with severe mental illness, people from racialised groups and people from different regions of the country," said lead study author Jayati Das-Munshi, MBBS, PhD, in a press release.

The authors concluded by emphasizing the importance of vaccines for SMI patients and the use of medical therapeutics early in the course of infection.

1 in 20 UK long-COVID patients still reported symptoms at 1 year

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Mary Van Beusekom, MS

Fatigued older man — jaboticaba / iStock

Adult long-COVID patients in England reported worse mental health and related quality of life than those who were never infected or recovered from their infections, suggests a study yesterday in Nature Communications.

Imperial College London researchers analyzed self-reported mental health and quality of life among 276,840 participants from August to December 2022.

The team also used data from a follow-up survey of participants in the REal-time Assessment of Community Transmission-2 study, which included six rounds of random samples of the population to evaluate community prevalence of SARS-CoV-2 antibodies in England.

Women, those with severe infections most at risk

Overall, 59.1% of participants had tested positive for COVID-19. Symptoms among 130,251 respondents lasted for, on average, 5.4 weeks (range, 1 day to 3 years). In total, 7.5% and 5.2% reported symptoms for at least 12 weeks (long COVID) and 52 weeks or longer (very long COVID), respectively.

Risk factors for long or very long COVID included female sex (adjusted odds ratio [aOR], 1.42 and 1.49, respectively), having at least one underlying condition (aOR, 1.31 and 1.52), and moderate or severe COVID-19 (aOR, 1.76 and 1.47).

Although COVID-19 is usually of short duration, some adults experience persistent and burdensome illness, although a sizeable proportion still recover after a prolonged period.

The probability of long COVID and very long COVID was lower in Asian than in White people (aOR, 0.80 and 0.71, respectively) and in those infected during the Alpha (aOR, 0.60 and 0.59), Delta (OR, 0.38 and 0.32), or Omicron waves (OR, 0.12 for long COVID; insufficient follow-up time for very long COVID) than in those with wild-type infections.

The most common ongoing symptoms were mild fatigue (66.9%), difficulty thinking or concentrating (54.9%), and joint pain (54.6%). The greatest difference in symptom prevalence between those with ongoing symptoms and other participants were for altered smell (aOR, 9.31) or taste (aOR, 8.47), shortness of breath (aOR, 6.69), severe fatigue (aOR, 6.19), difficulty thinking or concentrating (aOR, 4.97), chest tightness or pain (aOR, 4.71), and memory loss (aOR, 4.40).

"Although COVID-19 is usually of short duration, some adults experience persistent and burdensome illness, although a sizeable proportion still recover after a prolonged period," the authors wrote.

Salmonella outbreak tied to diced onions sickens 73 people in 22 states

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Lisa Schnirring

The Centers for Disease Control and Prevention (CDC) yesterday announced a Salmonella Thompson outbreak linked to fresh diced onions that has sickened at least 73 people, some of them nursing home residents, in 22 states.

So far, 15 people have been hospitalized, and no deaths have been reported. The illnesses began on August 2, with September 25 as the latest illness-onset date. California and Utah have confirmed the most infections, each having 17 cases.

State and local health officials have been interviewing patients about their food exposures before they got sick, and, of 19 people with available information, 14 had eaten onions or had been served diced onions. Six patients live in long-term care facilities, and health officials identified a cluster of three patients from the same facility.

Recall of Gills Onions

Whole-genome sequencing suggested that the patients’ samples were closely related, suggesting that they were sickened by the same food source. A trace-back investigation led by the Food and Drug Administration (FDA) found that onions processed at Gills Onions were available in locations where people ate before getting sick. Also, meal records from long-term care facilities showed that people were served diced onions from Gills Onions. Gills onion label

Yesterday the company, based in Oxnard, California, recalled the fresh onions, which are sold in some stores and were distributed to restaurants and institutions in the United States and Canada. The recall notice, however, said the products subject to the recall were distributed in western states, including Arizona, California, Idaho, Montana, Oregon, and Washington.

The CDC said though the recalled products are past their use-by dates, from August 8 to August 28, customers may still have the products in their freezers and should throw them away or return them to the place of purchase.