The impact of the Covid-19 pandemic on patients with schizophrenia

Vita, Antonio; Barlati, Stefano

doi:10.1016/j.euroneuro.2021.08.003

Cited by 11 publications

(15 citation statements)

References 11 publications

(9 reference statements)

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“…In people living with severe mental disorders, the isolation resulting from lockdowns and containment measures, combined with the risk of a reduction of availability of pharmacological treatments and psychosocial interventions, could lead to a significant worsening of their clinical condition, including a higher risk of relapse ( Barlati et al., 2021 ; Hao et al., 2020 ; Thomas et al., 2020 ; Valdés-Florido et al., 2020 ; Vita and Barlati, 2022 ).…”

Section: Discussionmentioning

confidence: 99%

“…People suffering from mental health disorders have faced a great hardship during the pandemic, especially when considering major psychiatric diseases such as schizophrenia: recent literature highlights how people living with schizophrenia have an increased risk of contracting the virus and have a worse prognosis, considering both morbidity and mortality ( Barlati et al., 2021 ; Kozloff et al., 2020 ; Mohan et al., 2021 ; Vita and Barlati, 2022 ).…”

Section: Introductionmentioning

confidence: 99%

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Long-acting Injectable Antipsychotics during the COVID-19 pandemic in schizophrenia: An observational study in a real-world clinical setting

Barlati

Nibbio²,

Bianchi³

et al. 2022

Psychiatry Research

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Long-acting Injectable Antipsychotics during the COVID-19 pandemic in schizophrenia: An observational study in a real-world clinical setting

Barlati

Nibbio²,

Bianchi³

et al. 2022

Psychiatry Research

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“… 36 Their particular immunological profile and antipsychotic treatments can be associated with worse prognosis and higher mortality after a COVID‐19 infection. 23 , 26 , 36 Also, major psychiatric illness in community dwelling enrollees may be accompanied by severe socioeconomic deprivation, such as homelessness. 34 …”

Section: Discussionmentioning

confidence: 99%

Excess deaths from COVID‐19 among Medicare beneficiaries with psychiatric diagnoses: Community versus nursing home

Mehta

et al. 2022

J American Geriatrics Society

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Background Psychiatric illness may pose an additional risk of death for older adults during the COVID‐19 pandemic. Older adults in the community versus institutions might be influenced by the pandemic differently. This study examines excess deaths during the COVID‐19 pandemic among Medicare beneficiaries with and without psychiatric diagnoses (depression, anxiety, bipolar disorder, and schizophrenia) in the community versus nursing homes. Methods This is a retrospective cohort study of a 20% random sample of 15,229,713 fee‐for‐service Medicare beneficiaries, from January 2019 through December 2021. Unadjusted monthly mortality risks, COVID‐19 infection rates, and case‐fatality rates after COVID‐19 diagnosis were calculated. Excess deaths in 2020, compared to 2019 were estimated from multivariable logistic regressions. Results Of all included Medicare beneficiaries in 2020 ( N = 5,140,619), 28.9% had a psychiatric diagnosis; 1.7% lived in nursing homes. In 2020, there were 246,422 observed deaths, compared to 215,264 expected, representing a 14.5% increase over expected. Patients with psychiatric diagnoses had more excess deaths than those without psychiatric diagnoses (1,107 vs. 403 excess deaths per 100,000 beneficiaries, p < 0.01). The largest increases in mortality risks were observed among patients with schizophrenia (32.4% increase) and bipolar disorder (25.4% increase). The pandemic‐associated increase in deaths with psychiatric diagnoses was only found in the community, not in nursing homes. The increased mortality for patients with psychiatric diagnoses was limited to those with medical comorbidities. The increase in mortality for psychiatric diagnoses was associated with higher COVID‐19 infection rates (1‐year infection rate = 7.9% vs. 4.2% in 2020), rather than excess case fatality. Conclusions Excess deaths during the COVID‐19 pandemic were disproportionally greater in beneficiaries with psychiatric diagnoses, at least in part due to higher infection rates. Policy interventions should focus on preventing COVID‐19 infections and deaths among community‐dwelling patients with major psychiatric disorders in addition to those living the nursing homes.

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“…The most severe cases of COVID-19 can require hospitalisation and treatment in intensive care, and mortality is significant. Several studies have been performed to investigate the impact of COVID-19 on patients on clozapine treatment ( Govind et al , 2020 ; Vita and Barlati, 2021 ). In a previous study, we reported that patients on clozapine treatment may be at higher risk of COVID-19 infection ( Govind et al , 2020 ).…”

Section: Introductionmentioning

confidence: 99%

COVID-related hospitalization, intensive care treatment, and all-cause mortality in patients with psychosis and treated with clozapine

Ware

Freitas

Pritchard

et al. 2022

European Neuropsychopharmacology

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Clozapine, an antipsychotic, is associated with increased susceptibility to infection with COVID-19, compared to other antipsychotics. Here, we investigate associations between clozapine treatment and increased risk of adverse outcomes of COVID-19, namely COVID-related hospitalisation, intensive care treatment, and death, among patients taking antipsychotics with schizophrenia-spectrum disorders. Using the clinical records of South London and Maudsley NHS Foundation Trust, we identified 157 individuals who had an ICD-10 diagnosis of schizophrenia-spectrum disorders, were taking antipsychotics (clozapine or other antipsychotics) at the time of COVID-19 pandemic in the UK and had a laboratory-confirmed COVID-19 infection. The following health outcomes were measured: COVID-related hospitalisation, COVID-related intensive care treatment and death. We tested associations between clozapine treatment and each outcome using logistic regression models, adjusting for gender, age, ethnicity, neighbourhood deprivation, obesity, smoking status, diabetes, asthma, bronchitis and hypertension using propensity scores. Of the 157 individuals who developed COVID-19 while on antipsychotics (clozapine or other antipsychotics), there were 28% COVID-related hospitalisations, 8% COVID-related intensive care treatments and 8% deaths of any cause during the 28 days follow-up period. Among those taking clozapine, there were 25% COVID-related hospitalisations, 7% COVID-related intensive care treatments and 7% deaths. In both unadjusted and adjusted analyses, we found no significant association between clozapine and any of the outcomes. Thus, we found no evidence that patients with clozapine treatment at time of COVID-19 infection had increased risk of hospitalisation, intensive care treatment or death, compared to non-clozapine antipsychotic-treated patients. However, further research should be considered in larger samples to confirm this. schizophrenia clozapine Antipsychotic agents COVID-19 SARS-CoV-2

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The impact of the Covid-19 pandemic on patients with schizophrenia

Cited by 11 publications

References 11 publications

Long-acting Injectable Antipsychotics during the COVID-19 pandemic in schizophrenia: An observational study in a real-world clinical setting

Long-acting Injectable Antipsychotics during the COVID-19 pandemic in schizophrenia: An observational study in a real-world clinical setting

Excess deaths from COVID‐19 among Medicare beneficiaries with psychiatric diagnoses: Community versus nursing home

COVID-related hospitalization, intensive care treatment, and all-cause mortality in patients with psychosis and treated with clozapine

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