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

Barcella, Carlo Alberto; Polcwiartek, Christoffer; Mohr, Grímur Høgnason; Hodges, Gethin W.; Søndergaard, Kathrine Bach; Bang, Casper N.; Andersen, Mikkel Porsborg; Fosbøl, Emil Loldrup; Køber, Lars; Schou, Morten; Torp‐Pedersen, Christian; Kessing, Lars Vedel; Gislason, Gunnar; Kragholm, Kristian

doi:10.1111/acps.13309

Cited by 50 publications

(80 citation statements)

References 36 publications

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“…Overall, these results emphasize the importance of addressing the increased physical health risk profile in patients with BD. This is underlined by the results from a recent Danish register study showing that patients with BD, who had a positive COVID-19 test, had a more unfavorable physical illness outcome in comparison to patients with COVID-19 not having a severe mental illness ( 27 ). The present findings support the described recommendations made by Hernández-Gómez et al ( 1 ) and underline that patients with BD should be considered as an at-risk population, presumably, especially vulnerable to relapse during the pandemic.…”

Section: Discussionmentioning

confidence: 99%

Physical Health Profile and Associated Behavior During the COVID-19 Pandemic in Patients With Bipolar Disorder

et al. 2021

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Background: The COVID-19 pandemic has led to an increased psychological strain on public mental health and may impact behavioral, mental, and physical health, presumably with effects on patients with severe mental disorders. This study examines pandemic-related physical and mental health and (compensatory) behavioral changes, in patients with BD as compared to healthy control individuals.Method: Physical and mental health and self-reported changes in daily structure and behavior due to the pandemic were assessed using a self-constructed questionnaire and the brief symptom inventory (BSI) in Germany, Austria, and Denmark in individuals with BD and a healthy control group.Results: The present study included 118 individuals with BD and 215 healthy controls. Individuals with BD reported statistically significant higher physical risk burden, increased weight gain, more physical comorbidities, and a decrease in physical activity and they further reported higher rates of COVID-19 testing, had more worries concerning health, and experienced more anxiety but less social distancing.Conclusion: The COVID-19 pandemic seems to have a greater impact on physical health in individuals with BD than in healthy controls. Individuals with BD appear to be having more difficulties compensating their behavior due to the pandemic which could amplify the effect of risk factors associated with poorer physical health. This highlights the necessity for optimizing and targeting the overall treatment of both mental and physical health in patients with BD during periods with far-reaching changes such as the COVID-19 pandemic.Limitations: Sampling issues and self-report forms, selectivity (missing elderly, and those lacking access or knowledge of technology).

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Section: Discussionmentioning

confidence: 99%

Physical Health Profile and Associated Behavior During the COVID-19 Pandemic in Patients With Bipolar Disorder

et al. 2021

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“…Individuals in Denmark who tested positive for SARS-CoV-2 were found to have a much higher chance of dying and experiencing severe COVID-19 if they were previously diagnosed with a schizophrenia spectrum, bipolar disorder, or unipolar depression or filled a prescription for psychotropic drugs than individuals without psychiatric disorders [ 148 ]. Additionally, a study in Sweden found that individuals with severe mental disorders (e.g., psychotic and bipolar disorders) were almost twice as likely to experience a COVID-19 associated death, and these odds increased to four fold for individuals with severe mental disorders between the ages of 60 and 79 years old [ 149 ].…”

Section: Neuropsychiatric Disorders and Vulnerability To Covid-19mentioning

confidence: 99%

Biological and Psychological Factors Determining Neuropsychiatric Outcomes in COVID-19

Tizenberg

Brenner

Lowry

et al. 2021

Curr Psychiatry Rep

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Purpose of Review We present biological and psychological factors implicated in psychiatric manifestations of SARS-CoV-2, as well as its neuroinvasive capability and immune pathophysiology. Recent Findings Preexisting mental illness leads to worse clinical outcomes in COVID-19. The presence of the virus was reported in the cerebrospinal fluid (CSF) and brain tissue post-mortem. Most common psychiatric manifestations include delirium, mood disorders, anxiety disorders, and posttraumatic stress disorder. “Long-COVID” non-syndromal presentations include “brain-fogginess,” autonomic instability, fatigue, and insomnia. Summary SARS-CoV-2 infection can trigger prior vulnerabilities based on the priming of microglia and other cells, induced or perpetuated by aging and mental and physical illnesses. COVID-19 could further induce priming of neuroimmunological substrates leading to exacerbated immune response and autoimmunity targeting structures in the central nervous system (CNS), in response to minor immune activating environmental exposures, including stress, minor infections, allergens, pollutants, and traumatic brain injury.

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“…In a recent study, the prevalence of schizophrenia was 3.6% in 7,341 patients with COVID-19, much higher than the 0.66% prevalence in the general population (11)(12)(13). Previous studies have shown that people with mental illness are two to seven times more likely to die after a respiratory infection, and severe mental health disorders have been shown to be a risk factor for increased mortality from COVID-19 (13)(14)(15). Furthermore, extensive studies indicate that while COVID-19 is damaging to the respiratory system, it can also have negative mental health effects.…”

Section: Introductionmentioning

confidence: 96%

“…COVID-19 is caused by SARS-CoV-2, which belongs to the coronavirus family (15,18). Its pathogenicity is effected via the angiotensin-converting enzyme-2 receptor (ACE2) (19)(20)(21).…”

Section: Introductionmentioning

confidence: 99%

Immune Response Is Key to Genetic Mechanisms of SARS-CoV-2 Infection With Psychiatric Disorders Based on Differential Gene Expression Pattern Analysis

Xia

Chen

et al. 2022

Front. Immunol.

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Existing evidence demonstrates that coronavirus disease 2019 (COVID-19) leads to psychiatric illness, despite its main clinical manifestations affecting the respiratory system. People with mental disorders are more susceptible to COVID-19 than individuals without coexisting mental health disorders, with significantly higher rates of severe illness and mortality in this population. The incidence of new psychiatric diagnoses after infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is also remarkably high. SARS-CoV-2 has been reported to use angiotensin-converting enzyme-2 (ACE2) as a receptor for infecting susceptible cells and is expressed in various tissues, including brain tissue. Thus, there is an urgent need to investigate the mechanism linking psychiatric disorders to COVID-19. Using a data set of peripheral blood cells from patients with COVID-19, we compared this to data sets of whole blood collected from patients with psychiatric disorders and used bioinformatics and systems biology approaches to identify genetic links. We found a large number of overlapping immune-related genes between patients infected with SARS-CoV-2 and differentially expressed genes of bipolar disorder (BD), schizophrenia (SZ), and late-onset major depressive disorder (LOD). Many pathways closely related to inflammatory responses, such as MAPK, PPAR, and TGF-β signaling pathways, were observed by enrichment analysis of common differentially expressed genes (DEGs). We also performed a comprehensive analysis of protein–protein interaction network and gene regulation networks. Chemical–protein interaction networks and drug prediction were used to screen potential pharmacologic therapies. We hope that by elucidating the relationship between the pathogenetic processes and genetic mechanisms of infection with SARS-CoV-2 with psychiatric disorders, it will lead to innovative strategies for future research and treatment of psychiatric disorders linked to COVID-19.

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

Cited by 50 publications

References 36 publications

Physical Health Profile and Associated Behavior During the COVID-19 Pandemic in Patients With Bipolar Disorder

Physical Health Profile and Associated Behavior During the COVID-19 Pandemic in Patients With Bipolar Disorder

Biological and Psychological Factors Determining Neuropsychiatric Outcomes in COVID-19

Immune Response Is Key to Genetic Mechanisms of SARS-CoV-2 Infection With Psychiatric Disorders Based on Differential Gene Expression Pattern Analysis

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