Study finds COVID-19 susceptibility for those with addiction

People with substance use disorders (SUDs) are more susceptible to the novel coronavirus (COVID-19) and its complications, according to a new National Institutes of Health-funded study published in the journal Molecular Psychiatry.

By analyzing non-identifiable electronic health records (EHR) of 73 million patients from 360 hospitals in the United States, the team of investigators found that while individuals with a substance use disorder (SUD) constituted 10.3 percent of the total study population, they represented 15.6 percent of the COVID-19 cases.

The study population consisted of 7.5 million patients who had been diagnosed with an SUD at some point in their lives. Slightly more than 12,000 were diagnosed with COVID-19, and about 1,880 had both an SUD and a COVID-19 diagnosis on record. The types of SUDs investigated in the study were tobacco, alcohol, opioid, cannabis, and cocaine.

The complicating effects of SUD were visible in increased adverse consequences of COVID-19, the researchers said. Hospitalizations and death rates of COVID-19 patients were all elevated in people with recorded SUDs compared to those without—41.0 percent versus 30.1 percent and 9.6 percent versus 6.6 percent, respectively.

Additionally, Blacks with a recent opioid use disorder diagnosis were over four times more likely to develop COVID-19, compared to whites. Results showed that hypertension, diabetes, cardiovascular diseases, and renal diseases, which are risk factors for COVID-19, were more prevalent among Blacks than whites with opioid use disorder.

The analysis showed that those with a recent SUD diagnosis on record were more likely than those without to develop COVID-19, an effect that was strongest for opioid use disorder, followed by tobacco use disorder. Individuals with an SUD diagnosis were also more likely to experience worse COVID-19 outcomes, hospitalization and death, than people without an SUD, according to the study.

The authors said the study findings underscore the need to screen for, and treat, SUDs as part of the strategy for controlling the COVID-19 pandemic. Additional research needs to be done to better understand how best to treat those with SUDs who are at risk for COVID-19 and counsel on how to avoid the risk of infection, they said.

“The lungs and cardiovascular system are often compromised in people with SUD, which may partially explain their heightened susceptibility to COVID-19,” said Nora Volkow, MD, study co-author and director of the National Institute on Drug Abuse. “Another contributing factor is the marginalization of people with addiction, which makes it harder for them to access healthcare services. 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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