The effects of substance use on severe acute respiratory syndrome coronavirus infection risks and outcomes

Abstract

Purpose of review Severe acute respiratory syndrome coronavirus (SARS-CoV2) infection rates are currently occurring at alarmingly accelerated rates. There is also a long-standing and concurrent rise in the prevalence and severity of substance use disorders (SUD). Therefore, the intersection between these two conditions needs to be carefully considered to ensure a more effective delivery of healthcare. Recent findings Generally, those with SUDs are more likely to have higher risk social determinants of health factors. Therefore, these patients are more likely to have barriers that can create difficulties in following appropriate infection control measures which in turn increases the risk of exposure to SARS-CoV2. In addition, these individuals have higher rates of medical comorbidities which increases the risk of all adverse outcomes, including mortality, from SARS-CoV2 infection. Summary Individuals with SUDs are at increased risk of both contracting SARS-CoV2 infection and suffering from worse outcomes afterwards. Though these risks of adverse outcomes are specific of SARS-CoV2 infection, the risk of exposure to other infectious diseases is increased in this population too. Healthcare providers and policymakers should then consider how to better protect this at-risk population and alleviate this increased disease burden.

Risk of COVID-19 infection and the associated hospitalization, ICU admission and mortality in opioid use disorder: a systematic review and meta-analysis

“…In line with the literature, the present research showed increased risks of COVID-19-associated mortality in patients with OUD, which can stem from biological processes such as immunosuppression and elevated cytokine concentration [22,27,55]. Saeedi et al reported significant associations between OUD and mortality in patients with COVID-19 (OR (95% CI): 3.59, (0.9-14.5)) [34].…”

Prevalence of COVID-19 and Psychotropic Drug Treatment in Psychiatric In-patients in Germany in 2020: Results from a Nationwide Pilot Survey

“…Further, patients with mental disorders have been reported to have a more severe outcome of COVID-19, including admission to an intensive care unit and death, as evidenced by numerous studies [19,21,25,26] and corroborated by a meta-analysis [20]. The same seems to hold true for a pre-existing substance abuse disorder [27]. In a study by Fond et al [24], older patients with a diagnosis of schizophrenia had a higher risk for death than the control group, but interestingly, less admissions to an intensive care unit were observed, indicating disparities in health care between patients with and without a severe mental disorder.…”

Cannabis use, abuse and dependence during the COVID-19 pandemic: a scoping review

“…Certainly, substance dependence is associated with (often untreated) somatic comorbidity, such as cardiovascular diseases, diabetes mellitus, COPD, renal diseases, cancer and severe mental disorders (Farhoudian et al 2020;Balaram et al 2021), and the severity of these associated comorbidity is yet regarded as the primary risk factor for worse/fatal outcomes of COVID-19 (Farhoudian et al 2020;Hoertel et al 2022) but also of other infectious epidemic/pandemic diseases, such as influenza or AIDS. Further investigating the immune/resilience-modulatory role of addictive substances, such as opioids and cannabis/cannabinoids (Friedman et al 2006, Malinowska et al 2021, Paland et al 2021, van Breemen et al 2022, and non-addictive substances, such as antidepressants (Bonnet and Juckel 2022) and natural antioxidants (Choe et al 2022), appears to be a promising challenge to find new therapeutic or preventive approaches for improving the prognosis of COVID-19 and Long-COVID.…”