Risk of death in individuals hospitalized for COVID-19 with and without psychiatric disorders: an observational multicenter study in France. Hoertel N, Sánchez-Rico M, Muela P, Abellán M, Blanco C, Leboyer M, Cougoule C, Gulbins E, Kornhuber J, Carpinteiro A, Becker KA, Vernet R, Beeker N, Neuraz A, Alvarado JM, Herrera-Morueco JJ, Airagnes G, Lemogne C, Limosin F.Biol Psychiatry Glob Open Sci. 2022 Jan 4;. doi: 10.1016/j.bpsgos.2021.12.007. [Epub ahead of print] PubMed PMID: 35013734; PubMed Central PMCID: PMC8730644. OPEN ACCES. Download from HAL-INSERM
Background: Prior research suggests that psychiatric disorders could be linked to increased mortality among patients with COVID-19. However, whether all or specific psychiatric disorders are intrinsic risk factors of death in COVID-19, or whether these associations reflect the greater prevalence of medical risk factors in people with psychiatric disorders, has yet to be evaluated.
Methods: We performed an observational multicenter retrospective cohort study to examine the association between psychiatric disorders and mortality among patients hospitalized for laboratory-confirmed COVID-19 at 36 Greater Paris University hospitals.
Results: Of 15,168 adult patients, 857 (5.7%) had an ICD-10 diagnosis of psychiatric disorder. Over a mean follow-up of 14.6 days (SD=17.9), death occurred in 326/857 (38.0%) patients with a diagnosis of psychiatric disorder versus 1,276/14,311 (8.9%) in patients without such a diagnosis (OR=6.27; 95%CI=5.40-7.28; p<0.01). When adjusting for age, sex, hospital, current smoking status, and medications according to compassionate use or as part of a clinical trial, this association remained significant (AOR=3.27; 95%CI=2.78-3.85; p<0.01). However, additional adjustments for obesity and number of medical conditions resulted in a non-significant association (AOR=1.02; 95%CI=0.84-1.23; p=0.86). Exploratory analyses following the same adjustments suggest that a diagnosis of mood disorders was significantly associated with reduced mortality, which might be explained by the use of antidepressants.
Conclusions: These findings suggest that the increased risk of COVID-19-related mortality in individuals with psychiatric disorders hospitalized for COVID-19 might be explained by the greater number of medical conditions and the higher prevalence of obesity in this population, but not by the underlying psychiatric disease.
Keywords: COVID-19; SARS-COV-2; antidepressants; comorbidity; mental disorders; mood disorders; mortality; obesity; psychiatric disorders; risk of death.
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