Wang Q, Kaelber D, Xu R, Volkow N. (2020). COVID-19 risk and outcomes in patients with substance use disorders: analyses from electronic health records in the United States. Molecular Psychiatry. doi: 10.1038/s41380-020-00880-7
Researchers conducted a retrospective case-control study of electronic health record (EHR) data from 73,099,850 U.S. adults to analyze the risks and outcomes for COVID-19 among patients with substance use disorder (SUD). Patient EHR data came from the IBM Watson Explorys (a cloud-based platform with an EHR database). Statistical analysis revealed that SUD and race put individuals at significantly increased risk of developing COVID-19. Among patients with SUD, individuals with opioid use disorder (OUD) were over 10 times more likely to develop COVID-19, compared with individuals without OUD. Individuals with a recent SUD diagnosis were almost 9 times more likely to develop COVID-19 than individuals without this diagnosis. African Americans with a recent SUD diagnosis were 2 times more likely to develop COVID-19, and those with a specific diagnosis of OUD were 4 times more likely to develop COVID-19, compared with Caucasian Americans with the same diagnoses. Individuals with SUD who developed COVID-19 also experienced significantly worse health outcomes (African Americans, in particular). Rates of hospitalization and death were significantly higher among individuals with both SUD and COVID-19 (hospitalization: 41.0%, death: 9.6%) than among COVID-19 patients without SUD (hospitalization: 30.1% death: 6.6%). Rates of hospitalization and death were 44.0% and 51.2% higher, respectively, among African Americans with both lifetime SUD and COVID-19 (hospitalization: 50.7%, death: 13.0%), than among Caucasians with both diagnoses (hospitalization: 35.2%, death: 8.6%). Gender had no significant effects on health outcomes. Findings demonstrate the need to identify and treat individuals with SUD as a strategy to control the pandemic.