As we know, among the main factors that can affect the increased risk of severe COVID-19 and subsequent death - age (from 45 years and older), belonging to the male sex, obesity, cardiovascular diseases, hypertension, diabetes, smoking, Chronic obstructive pulmonary disease, chronic kidney disease and cancer. Studies in which the potential risk indicators of a severe or mortal coronavirus disease were also considered psychiatric diagnoses, were still limited.
The authors of the new work - the staff of the Langon Medical Center at the New York University and Institute of Psychiatric Research Nathan Clain in New York - decided to appreciate the relationship between mental disorders, including affective (mood disorders), anxiety and schizophrenic spectrum, and adult mortality, infected with coronavirus.
Based on previous studies of mortality from all reasons, they suggested that the risk of death will be elevated in all three psychiatric diagnostic groups, especially for patients with schizophrenic spectrum disorders. The work was published in Jama Psychiatry magazine.
Retrospective cohort analysis included 7348 patients (average age - 54 years; 53% - women; most were white) with a confirmed diagnosis of COVID-19. Some were also diagnosed with ICD-10: schizophrenic spectrum disorders (75 people, 1.0%), affective (564, 7.7%) or alarming (360, 4.9%). The study was conducted from March 3 to May 3, 2020. Mortality was determined as death or direction in the hospice 40 days after a positive test result.
As a result, it turned out that compared with patients with COVID-19, which did not have a schizophrenic spectrum disorders, the risk of mortality sufferers suffering from the study was more than twice as high. "After adjusting demographic and medical factors, the risk of schizophrenic spectrum disorder was significantly associated with mortality (risk higher than 2.67-3.13 times). At the same time, after the same adjustment of the substantial connection between affective disorders (the risk was 1.14 times higher) and the alarming (0.96 times) did not find it. Compared to other risk factors, the diagnosis of Schizophrenia is inferior only to the age of significance of this connection with mortality. In general, 864 patients (11.8%) died or were discharged into a hospice within 45 days after a positive test result on SARS-COV-2, "write the authors of work.
According to them, the findings of the study are expected, since patients with mental disorders often suffer from other diseases, including cardiovascular. "What has become a surprise, so this is a high risk of mortality related precisely with the disorders of the schizophrenic spectrum, which took only second place after age among all the demographic and medical factors studied by us," Katlin Nemani, a lead author of the work.
She proposed two possible explanations: the risk associated with drugs for the treatment of schizophrenic spectrum disorders, or an abnormal immune response to an infection. "On the relationship between serious infection and psychosis speak for decades. This suggests that a higher risk of death in patients with schizophrenia may not be unique to COVID-19, "she added. - Some studies suggest a higher risk of death from respiratory diseases associated with some antipsychotic drugs. " However, the Medic stressed that severe infections, as a rule, arise until the diagnosis of "schizophrenia" arise, so antipsychotics cannot be fully explained by this increased risk of mortality.
It is worth noting some restrictions on research: the accuracy of clinical psychiatric diagnoses could not be confirmed for all participants, and the use of psychotropic drugs during infection was not evaluated. In addition, according to the authors of work, people suffering from mental disorders, people with a smaller probability will seek medical care, although all patients in the study described still have previously passed the treatment. In the future, experts plan to explore both possible explanations of the relationship between the disorders of the schizophrenic spectrum and COVID-19.
Source: Naked Science