tetano
Editor, Senior Moderator
Acta Psychiatr Scand
. 2021 Apr 24.
doi: 10.1111/acps.13309. Online ahead of print.
Severe mental illness is associated with increased mortality and severe course of COVID-19
Carlo Alberto Barcella[SUP] 1 [/SUP], Christoffer Polcwiartek[SUP] 2 [/SUP], Grimur H?gnason Mohr[SUP] 1 3 [/SUP], Gethin Hodges[SUP] 1 [/SUP], Kathrine S?ndergaard[SUP] 1 [/SUP], Casper Bang[SUP] 4 5 [/SUP], Mikkel Porsborg Andersen[SUP] 5 [/SUP], Emil Fosb?l[SUP] 6 [/SUP], Lars K?ber[SUP] 6 [/SUP], Morten Schou[SUP] 1 [/SUP], Christian Torp-Pedersen[SUP] 2 5 [/SUP], Lars Vedel Kessing[SUP] 7 8 [/SUP], Gunnar Gislason[SUP] 1 9 [/SUP], Kristian Kragholm[SUP] 2 [/SUP]
Affiliations
Abstract
Objective: Psychiatric disorders have been associated with unfavorable outcome following respiratory infections. Whether this also applies to coronavirus disease 2019 (COVID-19) has been scarcely investigated.
Methods: Using the Danish administrative databases, we identified all patients with a positive real-time reverse transcription-polymerase chain reaction test for COVID-19 in Denmark up to and including January 2, 2021. Multivariable Cox regression was used to calculate 30-day absolute risk and average risk ratio (ARR) for the composite endpoint of death from any cause and severe COVID-19 associated with psychiatric disorders, defined using both hospital diagnoses and redemption of psychotropic drugs.
Results: We included 144,321patients with COVID-19. Compared with patients without psychiatric disorders, the standardized ARR of the composite outcome was significantly increased for patients with severe mental illness including schizophrenia spectrum disorders 2.43 (95% confidence interval [CI], 1.79-3.07), bipolar disorder 2.11 (95% CI, 1.25-2.97), unipolar depression 1.70 (95% CI, 1.38-2.02), and for patients who redeemed psychotropic drugs 1.70 (95% CI, 1.48-1.92). No association was found for patients with other psychiatric disorders 1.13 (95% CI, 0.86-1.38). Similar results were seen with the outcomes of death or severe COVID-19. Among the different psychiatric subgroups, patients with schizophrenia spectrum disorders had the highest 30-day absolute risk for the composite outcome 3.1% (95% CI, 2.3-3.9%), death 1.2% (95% CI, 0.4-2.0%) and severe COVID-19 2.7% (95% CI, 1.9-3.6%).
Conclusion: Schizophrenia spectrum disorders, bipolar disorder, unipolar depression and psychotropic drug redemption are associated with unfavourable outcomes in patients with COVID-19.
Keywords: Covid-19; bipolar disorder; depression; respiratory infection; schizophrenia; unfavourable outcome.
. 2021 Apr 24.
doi: 10.1111/acps.13309. Online ahead of print.
Severe mental illness is associated with increased mortality and severe course of COVID-19
Carlo Alberto Barcella[SUP] 1 [/SUP], Christoffer Polcwiartek[SUP] 2 [/SUP], Grimur H?gnason Mohr[SUP] 1 3 [/SUP], Gethin Hodges[SUP] 1 [/SUP], Kathrine S?ndergaard[SUP] 1 [/SUP], Casper Bang[SUP] 4 5 [/SUP], Mikkel Porsborg Andersen[SUP] 5 [/SUP], Emil Fosb?l[SUP] 6 [/SUP], Lars K?ber[SUP] 6 [/SUP], Morten Schou[SUP] 1 [/SUP], Christian Torp-Pedersen[SUP] 2 5 [/SUP], Lars Vedel Kessing[SUP] 7 8 [/SUP], Gunnar Gislason[SUP] 1 9 [/SUP], Kristian Kragholm[SUP] 2 [/SUP]
Affiliations
- PMID: 33894064
- DOI: 10.1111/acps.13309
Abstract
Objective: Psychiatric disorders have been associated with unfavorable outcome following respiratory infections. Whether this also applies to coronavirus disease 2019 (COVID-19) has been scarcely investigated.
Methods: Using the Danish administrative databases, we identified all patients with a positive real-time reverse transcription-polymerase chain reaction test for COVID-19 in Denmark up to and including January 2, 2021. Multivariable Cox regression was used to calculate 30-day absolute risk and average risk ratio (ARR) for the composite endpoint of death from any cause and severe COVID-19 associated with psychiatric disorders, defined using both hospital diagnoses and redemption of psychotropic drugs.
Results: We included 144,321patients with COVID-19. Compared with patients without psychiatric disorders, the standardized ARR of the composite outcome was significantly increased for patients with severe mental illness including schizophrenia spectrum disorders 2.43 (95% confidence interval [CI], 1.79-3.07), bipolar disorder 2.11 (95% CI, 1.25-2.97), unipolar depression 1.70 (95% CI, 1.38-2.02), and for patients who redeemed psychotropic drugs 1.70 (95% CI, 1.48-1.92). No association was found for patients with other psychiatric disorders 1.13 (95% CI, 0.86-1.38). Similar results were seen with the outcomes of death or severe COVID-19. Among the different psychiatric subgroups, patients with schizophrenia spectrum disorders had the highest 30-day absolute risk for the composite outcome 3.1% (95% CI, 2.3-3.9%), death 1.2% (95% CI, 0.4-2.0%) and severe COVID-19 2.7% (95% CI, 1.9-3.6%).
Conclusion: Schizophrenia spectrum disorders, bipolar disorder, unipolar depression and psychotropic drug redemption are associated with unfavourable outcomes in patients with COVID-19.
Keywords: Covid-19; bipolar disorder; depression; respiratory infection; schizophrenia; unfavourable outcome.