Individuals with psychotic disorders who were hospitalized for COVID-19 in Iran had lower survival rates and more severe illness than people with no mental health disorders, according to a study issued by the Journal of Neuropsychiatry and Clinical Neurosciences.
Mojtaba Sharafkhah, M.D., of Western University in London, Ontario, and colleagues analyzed data from 7,370 adults (average age 43, 44% women) who had been hospitalized with COVID-19 in one of three Iranian hospitals between April 2020 and October 2023. The researchers compared the outcomes of adults with any preexisting psychotic disorder, including schizophrenia and bipolar disorder, and those with no mental health disorder. The researchers excluded patients with common mental illnesses, such as anxiety or non-psychotic depression. All patients received COVID-19 treatment according to the national standard of care protocol.
Overall, 12% of the hospitalized COVID-19 patients had a psychotic disorder. Compared with patients with no mental illness, these patients were more likely to be women (68%), younger (average age 33), and to be smokers. They also were more likely to have comorbid medical conditions such as diabetes, dementia, immunocompromised states, and respiratory diseases.
Compared with patients with no mental illness, COVID-19 patients with a psychotic disorder had a higher rate of intensive care unit admission (45% vs 22%, respectively) and were also more likely to require oxygen therapy and ventilator support. The in-hospital mortality rate was also significantly higher among those with psychotic disorders (39%) versus those with no mental illness (24%).
The findings highlight the need for enhanced COVID-19 prevention protocols in populations with psychotic disorders, according to the researchers. “Beyond standard measures for COVID-19 prevention, such as vaccination and masking, targeted strategies should address specific risk factors, such as managing vascular conditions, promoting smoking cessation, and monitoring for atypical symptoms,” they wrote. “Additionally, early detection efforts are critical, given the tendency of patients with [psychotic disorders] to delay care seeking after symptom onset.”