Adherence reduces healthcare utilization and costs, so adherence is not only clinically effective but also economically efficient. However, less than one-quarter of this population remained adherent over the 4-year period, suggesting that strategies are needed to improve adherence.
For the old patients who are taking drugs, such as NSAIDs and aspirin, concomitant use of PPIs or H2 receptor antagonists should be considered to protect from the development of PUD. H. pylori eradication has been confirmed again to be essential for the treatment of PUD patients infected with H. pylori.
Aims: Patients with mental illness are vulnerable to SARS-CoV-2 infection because of behavioral changes associated with cognitive deterioration, especially without their caregivers. While studies have reported that SARS-CoV-2 infection risk and severe clinical outcomes are high among patients with mental illness, there is a lack of quantitative research supporting this claim. This study investigates if SARS-CoV-2 infection and Coronavirus Disease 2019 (COVID-19)-related death is higher in patients with mental illness than among those without a mental disorder. Methods: A cohort study was conducted using the COVID-19 database of National Health Insurance Service in South Korea. A total of 123,480 patients aged ≥20 years who visited a hospital between January 1, 2020, and May 30, 2020 were analyzed. Mental disorder diagnoses and types were determined based on 2019 medical records, and a multivariate logistic regression model was used to calculate the odds ratios (ORs) for SARS-CoV-2 infection and deaths.
Results:The ORs for SARS-CoV-2 infection (OR: 1.58; 95% CI: 1.45-1.71) and COVID-19related death (OR: 2.18; 95% CI: 1.57-3.04) were high among patients with mental illness. The OR of SARS-CoV-2 infection was higher among patients with severe mental illness (OR: 2.60; 95% CI: 2.21-3.06), dementia (OR: 1.90; 95% CI: 1.62-2.22), and substance use disorder (OR: 4.98, 95% CI: 3.60-6.88). The OR for COVID-19-related death was high among patients with severe mental illness (OR: 3.53; 95% CI: 1.82-6.83) and dementia (OR: 2.12; 95% CI: 1.39-3.22). Conclusions: Patients with mental illness are at high risk for SARS-CoV-2 infection and COVID-19-related death. Behavioral changes associated with cognitive deterioration and long-term care facility residence increase SARS-CoV-2 infection risk, and severe medical conditions and delayed treatment increase the COVID-19-related mortality risk in patients with mental illness. Patients with mental illness are a priority target population for COVID-19 prevention and treatment, and it is important to plan prevention measures that address their needs.
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