Mood Disorders and Outcomes of COVID-19 Hospitalizations

Abstract

The authors sought to characterize the association between prior mood disorder diagnosis and hospital outcomes among individuals admitted with COVID-19 to six Eastern Massachusetts hospitals.Methods: A retrospective cohort was drawn from the electronic health records of two academic medical centers and four community hospitals between February 15 and May 24, 2020. Associations between history of mood disorder and in-hospital mortality and hospital discharge home were examined using regression models among any hospitalized patients with positive tests for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).Results: Among 2,988 admitted individuals, 717 (24.0%) had a prior mood disorder diagnosis. In Cox regression models adjusted for age, sex, and hospital site, presence of a mood disorder prior to admission was associated with greater in-hospital mortality risk beyond hospital day 12 (crude hazard ratio=2.156, 95% CI=1.540, 3.020; fully adjusted hazard ratio=1.540, 95% CI=1.054, 2.250). A mood disorder diagnosis was also associated with greater likelihood of discharge to a skilled nursing facility or other rehabilitation facility rather than home (crude odds ratio=2.035, 95% CI=1.661, 2.493; fully adjusted odds ratio=1.504, 95% CI=1.132, 1.999).Conclusions: Hospitalized individuals with a history of mood disorder may be at risk for greater COVID-19 morbidity and mortality and are at increased risk of need for postacute care. Further studies should investigate the mechanism by which these disorders may confer elevated risk.

Cross-National Variations in COVID-19 Mortality: The Role of Diet, Obesity and Depression

“…The results of this study suggest that significant positive relationships exist between the point prevalence of depression and obesity and the COVID-19 crude mortality rate across countries. These results are consistent with the results of earlier research which has found that both these disorders confer an added risk of mortality in COVID-19 patients [13,[17][18][19]28,29]. On bivariate analyses, sugar consumption was also associated with the crude mortality rate; however, on multivariate analyses, this relationship, unlike the former two, was no longer statistically significant.…”

“…Recently, evidence has emerged suggesting a significant link between the presence of comorbid depression and an increased risk of mortality. This association has been observed in hospitalized patients [17], in retrospective analyses of health records [18,19] and in ecological analyses of population-level data [13]. The consistency of this association across different study designs and populations suggests that it is unlikely to be a chance finding.…”

Risk of Death in Individuals Hospitalized for COVID-19 With and Without Psychiatric Disorders: An Observational Multicenter Study in France

“…Prior studies ( 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 ) suggest that psychiatric disorders, including schizophrenia spectrum disorders ( 1 , 2 , 3 , 4 , 7 ), mood disorders ( 1 , 2 , 3 , 8 ), anxiety disorders ( 1 ), intellectual and developmental disabilities ( 9 ), substance-induced psychiatric disorders ( 1 , 2 ), and dementia ( 5 ) are associated with higher COVID-19-related mortality. However, premature mortality observed in patients with psychiatric disorders are usually attributable to comorbid medical illnesses ( 11 , 12 ), which themselves are associated with increased COVID-19-related mortality ( 13 ).…”

“…However, only 9 of 23 studies included in this meta-analysis adjusted for a limited number of comorbid medical conditions. Furthermore, few studies ( 4 , 8 ) examined the risk of mortality by psychiatric diagnosis in hospitalized patients with COVID-19. For example, Nemani and colleagues ( 4 ) found that a premorbid diagnosis of a schizophrenia spectrum disorder was significantly associated with increased mortality, while Castro and colleagues ( 8 ) reported a significant positive association between mood disorders and COVID-19 mortality.…”

Real-world effectiveness of repeated ketamine infusions for treatment resistant depression during the COVID-19 pandemic

“…Indeed, social support is a key factor in maintaining good physical and psychological health, resilience to stress, and achieving positive outcomes in individuals with mood disorders ( Ozbay et al, 2007 ; Wang et al, 2018 ). Furthermore, individuals with mood disorders are at greater risk of COVID-19-related morbidity and mortality, and needing post-acute care after hospital discharge ( Castro et al, 2021 ). Despite the well-demonstrated negative effects of social isolation measures on overall health outcomes, especially in individuals with prior mood disorders, no study has yet investigated the impact of these measures on the outcomes of individuals receiving antidepressant therapies.…”