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Substance Use Disorder Linked to Increased Risk for COVID-19

Increased risk especially strong for those with opioid use disorder, tobacco use disorder

THURSDAY, Sept. 17, 2020 (HealthDay News) — Substance use disorder (SUD) is associated with a higher risk for COVID-19 than that seen in the general population, as well as worse outcomes, according to a study published online Sept. 14 in Molecular Psychiatry.

Quan Qiu Wang, from Case Western Reserve University in Cleveland, and colleagues examined electronic health record data from 73,099,850 unique patients, of whom 12,030 had a diagnosis of COVID-19. The authors assessed risks, disparities, and outcomes for COVID-19 in individuals with SUD.

The researchers found that patients with a diagnosis of SUD within the past year were at significantly increased risk for COVID-19 (adjusted odds ratio [aOR], 8.699), with an even stronger effect seen for individuals with opioid use disorder (aOR, 10.244). For individuals with tobacco use disorder, the aOR was 8.222. Among patients with a recent diagnosis of SUD, African Americans had a significantly higher risk for COVID-19 than Caucasians (aOR, 2.173), with a stronger effect observed among those with opioid use disorder (aOR, 4.162). Significantly worse outcomes were seen for COVID-19 patients with SUD versus general COVID-19 patients (death, 9.6 versus 6.6 percent; hospitalization, 41.0 versus 30.1 percent). In addition, compared with Caucasians, African Americans with COVID-19 and SUD had worse outcomes (death, 13.0 versus 8.6 percent; hospitalization, 50.7 versus 35.2 percent).

“The lungs and cardiovascular system are often compromised in people with SUD, which may partially explain their heightened susceptibility to COVID-19. Another contributing factor is the marginalization of people with addiction, which makes it harder for them to access health care services,” a coauthor said in a statement. “It is incumbent upon clinicians to meet the unique challenges of caring for this vulnerable population, just as they would any other high-risk group.”

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