Lindsey Wang|QuanQiu Wang|Pamela B. Davis|Nora D. Volkow|Rong Xu
Increased risk for <scp>COVID</scp>?19 breakthrough infection in fully vaccinated patients with substance use disorders in the United States between December 2020 and August 2021
Case Western Reserve University|Case Western Reserve University|Case Western Reserve University|National Institute on Drug Abuse|National Institutes of Health|Case Western Reserve University
individuals substance use disorders suds increased risk covid19 infection adverse outcomes infection though vaccines highly effective covid19 effectiveness individuals suds might curtailed compromised immune status greater likelihood exposures added waning vaccine immunity new sarscov2 variants populationbased cohort study assessed risk time trends outcomes disparities covid19 breakthrough infection fully vaccinated sud patients starting 14 days completion vaccination study included 579372 individuals 30183 diagnosis sud 549189 without diagnosis fully vaccinated december 2020 august 2021 contracted covid19 infection prior vaccination used trinetx analytics network platform access deidentified electronic health records 63 health care organizations us among sud patients risk breakthrough infection ranged 68 tobacco use disorder 78 cannabis use disorder significantly higher 36 nonsud population p0001 breakthrough infection risk remained significantly higher controlling demographics age gender ethnicity vaccine types sud subtypes except tobacco use disorder highest cocaine cannabis use disorders hazard ratio hr206 95 ci 130325 cocaine hr192 95 ci 139266 cannabis matched sud nonsud individuals lifetime comorbidities adverse socioeconomic determinants health risk breakthrough infection longer differed populations except patients cannabis use disorder remained increased risk hr155 95 ci 122199 risk breakthrough infection higher sud patients received pfizer moderna vaccine hr149 95 ci 131169 vaccinated sud population risk hospitalization 225 breakthrough cohort 16 nonbreakthrough cohort risk ratio rr144 95 ci 10192042 risk death 17 05 respectively rr35 95 ci 174705 significant age gender ethnic disparities breakthrough infection observed vaccinated sud patients data suggest fully vaccinated sud individuals higher risk breakthrough covid19 infection largely due higher prevalence comorbidities adverse socioeconomic determinants health compared nonsud individuals high frequency comorbidities sud patients also likely contribute high rates hospitalization death following breakthrough infection