Monday, October 5, 2020

History of Psychiatric Illness May Increase Risk of Death From COVID-19

Patients hospitalized for COVID-19 who have previously been diagnosed with a psychiatric disorder may be at higher risk of death than patients without a history of a psychiatric disorder, suggests an analysis in JAMA Network Open.

Luming Li, M.D., and colleagues at Yale University assessed the outcomes of 1,685 patients who were hospitalized with COVID-19 between February 15 and April 25 in Yale New Haven Health System hospitals. Based on electronic health record data, 28% of these patients had a history of psychiatric illness (this group included those with an active psychiatric condition, those in remission, and those who were in recovery at time of admission for COVID-19).

Overall, 144 of the 473 patients with a psychiatric diagnosis died from COVID-19, compared with 174 deaths among the 1,212 patients with no prior psychiatric diagnosis. Li and colleagues noted that the patients with a psychiatric history were more likely to be older and have a medical comorbidity such as cancer, heart failure, or diabetes. But even after factoring in these differences, patients with a prior psychiatric diagnosis hospitalized for COVID-19 had a 50% greater risk of death compared with patients with no psychiatric history.

“It is unclear why psychiatric illness predisposes to COVID-19–related mortality,” Li and colleagues wrote. “Psychiatric symptoms may arise as a marker of systemic pathophysiologic processes, such as inflammation, that may, in turn, predispose to mortality. Similarly, psychiatric disorders may augment systemic inflammation and compromise the function of the immune system, while psychotropic medications may also be associated with to mortality risk.”

To read more on this topic, see the Psychiatric News article “Psychological Stress May Not Be Only Route Of COVID-19’s Psychiatric Burden.”

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