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

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          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.

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          Collision of the COVID-19 and Addiction Epidemics

          Nora D. Volkow (2020)
          People with substance use disorder may be especially susceptible to COVID-19, and compromised lung function from COVID-19 could also put at risk those who have opioid use disorder and methamphetamine use disorder. This commentary describes the risks of the collision of the COVID-19 and addiction epidemics.
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            COVID-19 risk and outcomes in patients with substance use disorders: analyses from electronic health records in the United States

            Quan Qiu Wang, David Kaelber, Rong Xu … (2020)
            The global pandemic of COVID-19 is colliding with the epidemic of opioid use disorders (OUD) and other substance use disorders (SUD) in the United States (US). Currently, there is limited data on risks, disparity, and outcomes for COVID-19 in individuals suffering from SUD. This is a retrospective case-control study of electronic health records (EHRs) data of 73,099,850 unique patients, of whom 12,030 had a diagnosis of COVID-19. Patients with a recent diagnosis of SUD (within past year) were at significantly increased risk for COVID-19 (adjusted odds ratio or AOR = 8.699 [8.411–8.997], P < 10−30), an effect that was strongest for individuals with OUD (AOR = 10.244 [9.107–11.524], P < 10−30), followed by individuals with tobacco use disorder (TUD) (AOR = 8.222 ([7.925–8.530], P < 10−30). Compared to patients without SUD, patients with SUD had significantly higher prevalence of chronic kidney, liver, lung diseases, cardiovascular diseases, type 2 diabetes, obesity and cancer. Among patients with recent diagnosis of SUD, African Americans had significantly higher risk of COVID-19 than Caucasians (AOR = 2.173 [2.01–2.349], P < 10−30), with strongest effect for OUD (AOR = 4.162 [3.13–5.533], P < 10−25). COVID-19 patients with SUD had significantly worse outcomes (death: 9.6%, hospitalization: 41.0%) than general COVID-19 patients (death: 6.6%, hospitalization: 30.1%) and African Americans with COVID-19 and SUD had worse outcomes (death: 13.0%, hospitalization: 50.7%) than Caucasians (death: 8.6%, hospitalization: 35.2%). These findings identify individuals with SUD, especially individuals with OUD and African Americans, as having increased risk for COVID-19 and its adverse outcomes, highlighting the need to screen and treat individuals with SUD as part of the strategy to control the pandemic while ensuring no disparities in access to healthcare support.
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              COVID-19 and addiction

              Mahua Dubey, Ritwik Ghosh, Subham Chatterjee … (2020)
              Background and aims 2019-coronavirus disease (COVID-19) is causing insurmountable psychosocial impact on the whole mankind. Marginalized community, particularly those with substance use disorders (SUD), are particularly vulnerable to contract the infection and also likely to suffer from greater psychosocial burden. This article analyses the intricate bi-directional relationship between COVID-19 and addiction. Methods Pubmed and Google Scholar are searched with the following key terms- “COVID-19”, “SARS-CoV2”, “Pandemic”, “Addiction”, “Opioid”, “Alcohol”, “Smoking”, “Addiction Psychiatry”, “Deaddiction”, “Substance use disorders”, “Behavioral addiction”. Few newspaper reports related to COVID-19 and addiction have also been added as per context. Results People with SUD are at greater risk of worse COVID-19 outcome. There is surge of addictive behaviors (both new and relapse) including behavioral addiction in this period. Withdrawal emergencies and death are also being increasingly reported. Addicted people are especially facing difficulties in accessing the healthcare services which are making them prone to procure drugs by illegal means. Conclusion COVID-19 and addiction are the two pandemics which are on the verge of collision causing major public health threat. While every effort must be taken to make the public aware of deleterious effects of SUD on COVID-19 prognosis, the resumption of deaddiction services and easier accessibility of prescription drugs are needs of the hour.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Curr Opin Psychiatry
                Journal ID (iso-abbrev): Curr Opin Psychiatry
                Journal ID (publisher-id): COIP
                Title: Current Opinion in Psychiatry
                Publisher: Lippincott Williams & Wilkins (Hagerstown, MD )
                ISSN (Print): 0951-7367
                ISSN (Electronic): 1473-6578
                Publication date (Print): July 2021
                Publication date (Electronic): 17 May 2021
                Volume: 34
                Issue: 4
                Pages: 386-392
                Affiliations
                [a ]Department of Psychiatry, Case Western Reserve University
                [b ]Departments of Internal Medicine, Pediatrics, and Population and Quantitative Health Sciences, and the Center for Clinical Informatics Research and Education, Case Western Reserve University/The MetroHealth System, Cleveland, Ohio, USA
                Author notes
                Correspondence to Kripa Balaram, MD, Department of Psychiatry, The MetroHealth System, 2500 MetroHealth Drive, Cleveland, OH 44109, USA. E-mail: kbalaram@ 123456metrohealth.org
                Article
                Publisher ID: YCO340420 Accession ID: 00010
                DOI: 10.1097/YCO.0000000000000711
                PMC ID: 8183241
                PubMed ID: 34001701
                SO-VID: e30cb93e-33de-4151-b5b8-a1e27ecb8b4f
                Copyright © Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
                License:

                This article is made available via the PMC Open Access Subset for unrestricted re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the COVID-19 pandemic or until permissions are revoked in writing. Upon expiration of these permissions, PMC is granted a perpetual license to make this article available via PMC and Europe PMC, consistent with existing copyright protections.

                History
                Categories
                Subject: ADDICTIVE DISORDERS: Edited by John B. Saunders and Linda B. Cottler

                Keywords: coronavirus disease 2019,outcomes,risks,severe acute respiratory syndrome coronavirus,substance use disorders
                Data availability:
                Keywords: coronavirus disease 2019, outcomes, risks, severe acute respiratory syndrome coronavirus, substance use disorders

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