Substance Use Disorder and Health Outcomes in COVID-19 —the Need for a Better Research Method to Determine Substance Use Exposure

To the Editor We were excited to read the article by Schieber and colleagues that describes an impressively large, retrospective, cross-sectional study demonstrating that among patients presenting to the emergency department who tested positive for COVID-19 infection, individuals with both psychiatric and substance use disorder (SUD) diagnoses had greater probability of hospitalization compared with either disorder alone or neither disorder. The authors briefly describe an important limitation of the study: that the exposure of SUD was determined based on International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, coding at the previous or current health care visit, suggesting that SUD and psychiatric diagnoses might have been underdiagnosed or underreported due to undercoding or social desirability bias. We agree with their stated limitation; however, we believe that this should have been expounded.
Source: JAMA Psychiatry - Category: Psychiatry Source Type: research