Infectious Disease

Serious psychiatric disorders can worsen the results of COVID-19

November 24, 2021

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Disclosure:
One study author reports that outside of the work submitted, he has received grants from Compass Pathways and Relmada, as well as personal fees from Boehringer Ingelheim, Merck, and Johnson & Johnson. The other authors do not report any relevant financial information.

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Patients with severe psychiatric disorders appeared to have higher rates of medical comorbidities associated with poorer COVID-19 outcomes, according to results from a cross-sectional study published on JAMA Network Open.

However, the higher mortality rate was independent of comorbidities.

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The Optum COVID-19 Electronic Health Record contained 3,614,884 patient records sourced from a network of healthcare providers in the United States and provides a unique opportunity to assess the impact of COVID-19 on patients with psychiatric disorders at a nationally representative level ” Antonio L. Teixeira, MD, PhD, of the Department of Psychiatry and Behavioral Sciences at the University of Texas Health Science Center at Houston, and colleagues wrote. “By accessing this national COVID-19 EHR database, we wanted to investigate whether people with serious psychiatric illnesses had higher rates of infection and death from COVID-19. Given that people with serious psychiatric disorders have several factors linked to poorer COVID-19 outcomes, we assumed they were more prone to the infection. “

The researchers used EHR data collected from various national sources in the United States and licensed by Optum. They included current and historical data from patients tested for COVID-19 in 2020. They compared cohorts of patients with schizophrenia, mood disorders, or anxiety disorders with a reference group without serious psychiatric disorders. Laboratory-confirmed positivity for COVID-19 and mortality were used as exposures. As key findings and actions, the researchers examined the risk of testing positive for COVID-19 and the risk of dying from COVID-19 in 2020.

Teixiera and colleagues analyzed data from 2,535,098 individuals, of whom 3,350 had schizophrenia, 26,610 had mood disorders, and 18,550 had anxiety disorders. The median patient age was 44 years, 233,519 were non-Hispanic African American, 1,583,440 non-Hispanic Caucasian, and 1,580,703 were female.

The results showed a significantly lower positivity rate than that of the schizophrenia cohort (9.86%; adjusted OR = 0.9; 95% CI: 0.84–0.97) and the cohort with mood disorders (9.86; adjusted OR = 0.93; 95% CI, 0.87-0.99). compared to the anxiety disorder cohort (11.17%; adjusted OR = 1.05; 95% CI 0.98-1.12), which was close to the reference group (11.91%). Complete adjustment for demographic factors and comorbid diseases showed that patients with schizophrenia had an almost four-fold increased risk of death compared to the reference group (OR = 3.74; 95% CI 2.66-5.24). The risk of death in the COVID-19 cohort with mood disorders was 2.76 times higher than in the reference group (OR = 2.76; 95% CI, 2-3.81), and the anxiety disorder cohort had a 2.39 -fold higher risk of death than the reference group (OR = 2.39; 95% CI 1.68-3.27).

“The results of this study suggest that pandemic risk detection needs to be encouraged in certain groups of patients with psychiatric illness and may advance alternative approaches to COVID-19 disease testing and interventions to improve clinical outcomes,” Teixeira et al Colleagues.

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