Publication date: May 28, 2025

Schizophrenia is associated with substantial physical and psychiatric comorbidities that increase the risk of severe outcomes in COVID-19 infection. However, few studies have examined the differences in care and outcomes among people with schizophrenia throughout the pandemic. We hypothesized that rates of in-hospital mortality, admission to the intensive care unit (ICU), and length of stay differed among people with and without schizophrenia. We conducted a population-based retrospective cohort study using administrative health data from Ontario, Canada, which included individuals hospitalized for COVID-19 between February 2020 and October 2023. We compared mortality, ICU admission, and length of stay using regression models adjusted for age, sex, comorbidities, vaccination status, and sociodemographic characteristics. We evaluated 66 959 hospital admissions, 4. 3% (2884) of which involved people with schizophrenia. People with schizophrenia had a significantly decreased rate of ICU admission (adjusted Odds Ratio [OR]: 0. 74 [0. 67, 0. 82]), a longer length of stay (adjusted RR: 1. 25 [1. 21, 1. 30]), but a similar risk of mortality (adjusted OR: 1. 09 [0. 98, 1. 22]) as people without schizophrenia. Age modified the relationship between schizophrenia and ICU admission. People with schizophrenia aged 60-75 were substantially less likely to be admitted to the ICU relative to those without (18. 4% vs 26. 5%, P 

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