Some psychiatric patients at increased risk of COVID-19 hosp
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In the largest systematic review and meta-analysis to date on COVID-19 outcomes in individuals with psychiatric disorders, the odds of dying or being hospitalized following COVID-19 infection were determined to be twice as high in comparison to persons without mental disorders. The study also found ICU admission rates were not affected.

Researchers aimed to assess the specific risks of COVID-19-related mortality, hospitalization, and ICU admission associated with any pre-existing mental disorder, and specific diagnostic categories of mental disorders, and exposure to psychopharmacological drug classes.

In this systematic review and meta-analysis, researchers searched Web of Science, Cochrane, PubMed, and PsycINFO databases, for original studies reporting data on COVID-19 outcomes in patients with psychiatric disorders compared with controls. They modeled random-effects meta-analyses to estimate crude odds ratios (OR) for mortality after SARS-CoV-2 infection as the primary outcome, and hospitalization and ICU admission as secondary outcomes.

33 studies were included in the systematic review and 23 studies in the meta-analysis, comprising 1469731 patients with COVID-19, of whom 43938 had mental disorders.

- The presence of any mental disorder was associated with an increased risk of COVID-19 mortality. This association was also observed for psychotic disorders, mood disorders, substance use disorders, and intellectual disabilities, and developmental disorders but not for anxiety disorders.

- COVID-19 mortality was associated with exposure to antipsychotics, anxiolytics, and antidepressants.

- For psychotic disorders, mood disorders, antipsychotics, and anxiolytics, the association remained significant after adjustment for age, sex, and other confounders.

- Mental disorders were associated with an increased risk of hospitalization. No significant associations with mortality were identified for ICU admission.

- Subgroup analyses and meta-regression showed significant associations of baseline COVID-19 treatment setting and country with mortality.

Conclusively, pre-existing mental disorders, in particular, psychotic and mood disorders, and exposure to antipsychotics and anxiolytics were associated with COVID-19 mortality in both crude and adjusted models.

Lancet Psychiatry
Source: https://doi.org/10.1016/S2215-0366(21)00232-7
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