370. Toxoplasma gondii IgG Seropositivity is Associated with Increased Schizophrenia, Hospitalization, and 1-year Mortality— a Multicenter Research Network Study

Abstract

Background Despite Toxoplasma seropositivity found in about one-third of the global population, we lack information about the clinical outcomes of patients with past exposure to this parasite without the manifested disease. We aim to evaluate 1-year mortality and mental health diagnosis in patients with Toxoplasma IgG seropositivity. Methods We queried a federated national multicenter network to validate mortality risk differences between Toxoplasma IgG seropositive and seronegative patients from 2010 to 2021, excluding patients with active disease. We used propensity score matching to assess independent mental health outcomes and mortality risk 1-year after serology. Results We found 6244 patients with Toxoplasma IgG positivity without toxoplasmosis and 29,179 patients with negative Toxoplasma IgG. Patients with positive Toxoplasma IgG were slightly older (46.1 ± 17 vs. 45±16.5, p< 0.0001) and more likely to be Hispanic (15% vs. 12%, p< 0.0001). Toxoplasma gondii IgG seropositivity was more often present in patients with neoplasms (25% vs 22%, < 0.0001), type 2 diabetes mellitus (13% vs 12%, p=0.0284), and less likely in transplant recipients (7% vs. 8%, p=0.0015), and liver cirrhosis (5% vs 7%, p. < 0.0001). Propensity score matching to 6099 seronegative patients adjusted for age, gender, race, ethnicity, heart disease, transplant, neoplasm, and cirrhosis found that seropositive patients had an increased risk of 1-year mortality (OR: 1.2, CI: 1.06-1.4, p=0.0036) (Figure 1), hospitalization (OR:1.2, CI: 1.1-1.3, p< 0.0001) and schizophrenia (OR: 1.4, CI: 1.01-1.8, p=0.04). An increased risk was not seen with bipolar disorder (OR: 0.86, CI: 0.66-1.15, p=0.3206). Figure 1.Kaplan-Meier survival analysis comparing the survival probability of patients without toxoplasmosis with a positive toxoplasma IgG (purple line) to those with a negative Toxoplasma IgG (green line) Conclusion Toxoplasma IgG seropositivity without clinical disease is associated with an increased risk of one-year mortality, hospitalization, and schizophrenia diagnosis. Further prospective studies are needed to clarify the association of Toxoplasma exposure with schizophrenia and worse outcomes. Disclosures All Authors: No reported disclosures.