Analysis of COVID-19 Infection and Mortality Among Patients With Psychiatric Disorders, 2020

Abstract

Key Points Question Do people with major psychiatric disorders have greater odds of testing positive for COVID-19 and dying from it? Findings This cross-sectional study based on nationwide electronic health record data from 2 535 098 participants showed that the schizophrenia and mood disorder cohorts had significantly lower rates of positivity (9.86%) than the anxiety disorder cohort (11.17%) and the general population (11.91%). Conversely, patients with schizophrenia had a higher rate of death from COVID-19 than the reference group or those with mood disorders or anxiety disorders. Meaning This study suggests that patients with major psychiatric disorders may be more likely to have medical comorbidities associated with worse COVID-19 outcome and yet have a higher mortality rate independent of comorbidities.

Factors influencing COVID-19 Infection in older individuals: History of Alcohol Use Disorder, Major Depressive illness, genetic variation and current use of alcohol

“…The study found this relationship independent of any medical comorbidities the patients may have had. Our results are in agreement with the study by Teixera et al ( 29 ) that found increased infection among those with a history of mood disorders.…”

“…Additionally, a large-scale meta-analysis did not find a relationship between preexisting mood disorders and risk for infection, hospitalization and death ( 28 ). In contrast, a recent analysis of COVID-19 infection and mortality found the odds of mortality was 2.78 times greater among patients testing positive who had a history of mood disorders ( 29 ). The study found this relationship independent of any medical comorbidities the patients may have had.…”

Association Between the Use of Psychotropic Medications and the Risk of COVID-19 Infection Among Long-term Inpatients With Serious Mental Illness in a New York State–wide Psychiatric Hospital System

“…Patients with psychiatric disorders are more likely to have medical comorbidities associated with worse outcomes and have a higher mortality rate from COVID-19 independent of these medical risk factors. 1 , 2 , 3 , 4 , 5 Among psychiatric diagnoses, schizophrenia is associated with the greatest increase in mortality risk. 1 , 3 , 5 , 6 Although increased mortality risk after COVID-19 infection has been consistently observed among patients with psychiatric disorders, some studies have found lower rates of COVID-19 infection among patients with major psychiatric disorders.…”

“… 1 , 2 , 3 , 4 , 5 Among psychiatric diagnoses, schizophrenia is associated with the greatest increase in mortality risk. 1 , 3 , 5 , 6 Although increased mortality risk after COVID-19 infection has been consistently observed among patients with psychiatric disorders, some studies have found lower rates of COVID-19 infection among patients with major psychiatric disorders. 3 , 6 , 7 This finding may reflect a true decrease in infection rates, possibly owing to social isolation, or failure to detect infection among individuals who do not receive testing.…”

“… 1 , 3 , 5 , 6 Although increased mortality risk after COVID-19 infection has been consistently observed among patients with psychiatric disorders, some studies have found lower rates of COVID-19 infection among patients with major psychiatric disorders. 3 , 6 , 7 This finding may reflect a true decrease in infection rates, possibly owing to social isolation, or failure to detect infection among individuals who do not receive testing. 8 In contrast, inpatients residing in psychiatric treatment facilities are at high risk of viral exposure and often have greater access to testing.…”