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Infectious Diseases

Updated 21 September 2020

People with substance use disorders are more susceptible to severe Covid-19

Researchers analysed over 12 000 Covid-19 patients diagnosed with SUDs and found they are at higher risk of contracting the disease, as well as experiencing adverse outcomes.

  • US researchers have linked substance use to Covid-19 susceptibility, as well as severe outcomes
  • For their study, they focused on the use of alcohol, tobacco, and cannabis, among others
  • Based on their results, they suggest healthcare workers should closely monitor Covid-19 patients with SUDs 

A new study, funded by the National Institutes of Health (NIH), found that people with substance use disorders (SUDs) are more susceptible to Covid-19 and its complications.

The findings, published in Molecular Psychiatry, were based on an analysis of millions of US patients’ non-identifiable electronic health records (EHR).

The types of SUDs investigated were tobacco, alcohol, opioid, cannabis, and cocaine.

According to the study lead author, Dr Nora Volkow, director of the National Institute on Drug Abuse (NIDA) and colleagues, findings indicate that healthcare providers should closely monitor patients with SUDs, and, more importantly, develop action plans to help protect them from infection and severe outcomes.

Opioid use and smoking: highest risk

The research team used a study population of over 73 million patients, of whom over 7.5 million had been diagnosed with an SUD at some point in their lives.

The records indicated that just over 12 000 patients were diagnosed with Covid-19, and around 1 880 had both an SUD and a Covid-19 diagnosis on record.

Those with a recent SUD diagnosis were also found to be more likely than those without it to develop Covid-19. The effect was strongest for opioid use disorder, followed by tobacco use disorder.

The data also shows that patients with an SUD diagnosis stood a higher chance of experiencing worse Covid-19 outcomes, such as hospitalisation (41% vs. 30.1%) and death (9.6% vs. 6.6%), than patients without an SUD. 

Why is this the case?

"The lungs and cardiovascular system are often compromised in people with SUD, which may partially explain their heightened susceptibility to Covid-19," said Volkow in a news release.

"Another contributing factor is the marginalisation 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."

According to the authors, their study results indicate a need to screen for and treat SUDs as part of the strategy for controlling the Covid-19 pandemic.

They also added that further research is needed to understand how best to treat and counsel those with SUDs who are also at risk for Covid-19.