Severe mental illness is associated with increased mortality and severe course of COVID-19

Carlo Alberto Barcella*, Christoffer Polcwiartek, Grimur Høgnason Mohr, Gethin Hodges, Kathrine Søndergaard, Casper Niels Bang, Mikkel Porsborg Andersen, Emil Fosbøl, Lars Køber, Morten Schou, Christian Torp-Pedersen, Lars Vedel Kessing, Gunnar Gislason, Kristian Kragholm

*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

44 Citationer (Scopus)

Abstract

Objective: Psychiatric disorders have been associated with unfavourable 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 2 January 2021. Multivariable cox regression was used to calculate 30-day absolute risk and average risk ratio (ARR) for the composite end point 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 144,321 patients 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.

OriginalsprogEngelsk
TidsskriftActa Psychiatrica Scandinavica
Vol/bind144
Udgave nummer1
Sider (fra-til)82-91
Antal sider10
ISSN0001-690X
DOI
StatusUdgivet - 2021

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© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

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