Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jan 11;7(1):e31.
doi: 10.1192/bjo.2020.169.

Risk of adverse outcome of COVID-19 among patients in secure psychiatric services: observational cohort study

Natasa Basrak  1 , Naoise Mulcrone  1 , Sue Sharifuddin  1 , Zeshan Ghumman  1 , Nirvana Bechan  1 , Enas Mohamed  1 , Michael Murray  1 , Hariharan Rajendran  1 , Sean Gunnigle  1 , Mark Nolan  2 , Tim Quane  1 , Masashi Terao  1 , Tracey Hoare  1 , Kevin Kirrane  1 , Harry G Kennedy  3 , Mary Davoren  3
Affiliations

Risk of adverse outcome of COVID-19 among patients in secure psychiatric services: observational cohort study

Natasa Basrak et al. BJPsych Open. .

Abstract

Background: Secure forensic mental health services treat patients with high rates of treatment-resistant psychoses. High rates of obesity and medical comorbidities are common. Population-based studies have identified high-risk groups in the event of SARS-CoV-2 infection, including those with problems such as obesity, lung disease and immune-compromising conditions. Structured assessment tools exist to ascertain the risk of adverse outcome in the event of SARS-CoV-2 infection.

Aims: To assess risk of adverse outcome in the event of SARS-CoV-2 infection in a complete population of forensic psychiatry patients using structured assessment tools.

Method: All patients of a national forensic mental health service (n = 141) were rated for risk of adverse outcome in the event of SARS-CoV-2 infection, using two structured tools, the COVID-Age tool and the COVID-Risk tool.

Results: We found high rates of relevant physical comorbidities. Mean chronological age was 45.5 years (s.d. = 11.4, median 44.1), mean score on the COVID-Age tool was 59.1 years (s.d. = 19.4, median 58.0), mean difference was 13.6 years (s.d. = 15.6), paired t = 10.9, d.f. = 140, P < 0.001. Three patients (2.1%) were chronologically over 70 years of age, compared with 43 (30.5%) with a COVID-Age over 70 (χ2 = 6.99, d.f. = 1, P = 0.008, Fisher's exact test P = 0.027).

Conclusions: Patients in secure forensic psychiatric services represent a high-risk group for adverse outcomes in the event of SARS-COV-2 infection. Population-based guidance on self-isolation and other precautions based on chronological age may not be sufficient. There is an urgent need for better physical health research and treatment in this group.

Keywords: COVID-19; forensic mental health services; obesity; risk assessment; schizophrenia.

PubMed Disclaimer

Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Association between COVID-Risk tool score and COVID-Age tool score: Spearman's r = 0.776, P < 0.001, R2 = 0.4947.
Fig. 2
Fig. 2
Mean chronological age and mean COVID-Age score in each hospital unit.
See this image and copyright information in PMC

References

    1. Simpson AI, Chatterjee S, Darby P, Jones RM, Maheandiran M, Penney SR, et al. Management of COVID-19 response in a secure forensic mental health setting: réponse à la gestion de la COVID-19 dans un établissement sécurisé de santé mentale et de psychiatrie légale. Can J Psychiatry 2020; 65: 695–700. - PMC - PubMed
    1. Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med 2020; 382: 727–33. - PMC - PubMed
    1. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395: 497–506. - PMC - PubMed
    1. Guan W-J, Ni Z-Y, Hu Y, Liang W-H, Ou C-Q, He J-X, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020; 382: 1708–20. - PMC - PubMed
    1. Onder G, Rezza G, Brusaferro S. Case-fatality rate and characteristics of patients dying in relation to COVID-19 in Italy. JAMA 2020; 323: 1775–6. - PubMed