{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:57:47Z","timestamp":1782867467112,"version":"3.54.5"},"reference-count":42,"publisher":"American Medical Association (AMA)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi251107-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Given the increased vulnerability to COVID-19 among those with a serious mental illness (SMI), it remains unclear whether these individuals face a higher risk of developing postacute sequelae of SARS-CoV-2 (PASC). Understanding this association could inform secondary prevention efforts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi251107-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To identify the risk of developing PASC in patients with an SMI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi251107-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>This longitudinal cohort study used data derived from large-scale electronic health records (EHRs) between March 2020 and April 2023, inclusive of 180-day follow-up. Patients included adults aged 21 years or older with a confirmed COVID-19 infection evidenced by a relevant laboratory result, diagnosis, or prescription order.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi251107-7\">\n                    <jats:title>Exposures<\/jats:title>\n                    <jats:p>Evidence of an SMI diagnosis (schizophrenia, bipolar disorder, or recurrent major depressive disorder) recorded before COVID-19 infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi251107-8\">\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>Evidence of PASC symptoms within 30 to 180 days\u2019 follow-up after COVID-19 infection reported as odds ratios (OR) mutually adjusted for age, sex, race and ethnicity, insurance type, Charlson Comorbidity Index (CCI) score, and COVID-19 severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi251107-9\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 1\u202f625\u202f857 patients with a COVID-19 infection were included (mean [SD] age, 52 [17] years; 998\u202f237 [61.4%] female, 204\u202f237 [12.6%] non-Hispanic Black, 219\u202f220 [13.5%] Hispanic, 833\u202f411 [51.3%] non-Hispanic White, and 1\u202f228\u202f664 [75.6%] urban patients), of whom 258\u202f523 (15.9%) had an SMI and 403\u202f641 (24.8%) developed PASC. Individuals with an SMI had increased adjusted odds of developing PASC (OR, 1.10; 95% CI, 1.08-1.11;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&amp;amp;lt;\u2009.001). Variables associated with greater odds of PASC among the study population included older age compared with age 22 to 34 years (35 to 44 years: OR, 1.04; 95% CI, 1.03-1.06; 45 to 64 years: OR, 1.11; 95% CI, 1.10-1.12; \u226565 years: OR, 1.18; 95% CI, 1.17-1.20), non-Hispanic Black and Hispanic compared with non-Hispanic White race and ethnicity (non-Hispanic Black: OR, 1.08; 95% CI, 1.07-1.10; Hispanic: OR, 1.12; 95% CI, 1.11-1.13), higher chronic disease burden vs no chronic disease (CCI 1 to 3: OR, 1.13; 95% CI, 1.12-1.14; CCI \u22654: OR, 1.23; 95% CI, 1.22-1.25), and hospitalization with initial COVID-19 infection vs no hospitalization (hospitalized: OR, 1.80; 95% CI, 1.77-1.82; hospitalized with ventilation: OR, 2.17; 95% CI, 2.12-2.22;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&amp;amp;lt;\u2009.001). Compared with public insurance, commercial health insurance was associated with lower odds of PASC (OR, 0.85; 95% CI, 0.84-0.86).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi251107-10\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>In this cohort study of patients infected with COVID-19, patients with SMI compared with those without SMI were at increased risk of PASC, underscoring the need for coordinated mental health and COVID-19 care strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.40242","type":"journal-article","created":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T15:32:09Z","timestamp":1761751929000},"page":"e2540242","source":"Crossref","is-referenced-by-count":3,"title":["Schizophrenia, Bipolar, or Major Depressive Disorder and Postacute Sequelae of 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