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
. 2023 Jan;3(1):56-67.
doi: 10.1016/j.bpsgos.2021.12.007. Epub 2022 Jan 4.

Risk of Death in Individuals Hospitalized for COVID-19 With and Without Psychiatric Disorders: An Observational Multicenter Study in France

Nicolas Hoertel  1   2   3 , Marina Sánchez-Rico  1   4 , Pedro de la Muela  1   4 , Miriam Abellán  1 , Carlos Blanco  5 , Marion Leboyer  6   7 , Céline Cougoule  8 , Erich Gulbins  9 , Johannes Kornhuber  10 , Alexander Carpinteiro  9   11 , Katrin Anne Becker  9 , Raphaël Vernet  12 , Nathanaël Beeker  13 , Antoine Neuraz  14   15 , Jesús M Alvarado  4 , Juan José Herrera-Morueco  1   4 , Guillaume Airagnes  1 , Cédric Lemogne  16 , Frédéric Limosin  1 ; AP-HP/Université de Paris/Inserm COVID-19 Research Collaboration and the AP-HP COVID CDR Initiative, “Entrepôt de Données de Santé,” AP-HP Consortium
Collaborators, Affiliations

Risk of Death in Individuals Hospitalized for COVID-19 With and Without Psychiatric Disorders: An Observational Multicenter Study in France

Nicolas Hoertel et al. Biol Psychiatry Glob Open Sci. 2023 Jan.

Abstract

Background: Prior research suggests that psychiatric disorders could be linked to increased mortality among patients with COVID-19. However, whether all or specific psychiatric disorders are intrinsic risk factors of death in COVID-19 or whether these associations reflect the greater prevalence of medical risk factors in people with psychiatric disorders has yet to be evaluated.

Methods: We performed an observational, multicenter, retrospective cohort study to examine the association between psychiatric disorders and mortality among patients hospitalized for laboratory-confirmed COVID-19 at 36 Greater Paris University hospitals.

Results: Of 15,168 adult patients, 857 (5.7%) had an ICD-10 diagnosis of psychiatric disorder. Over a mean follow-up period of 14.6 days (SD = 17.9), 326 of 857 (38.0%) patients with a diagnosis of psychiatric disorder died compared with 1276 of 14,311 (8.9%) patients without such a diagnosis (odds ratio 6.27, 95% CI 5.40-7.28, p < .01). When adjusting for age, sex, hospital, current smoking status, and medications according to compassionate use or as part of a clinical trial, this association remained significant (adjusted odds ratio 3.27, 95% CI 2.78-3.85, p < .01). However, additional adjustments for obesity and number of medical conditions resulted in a nonsignificant association (adjusted odds ratio 1.02, 95% CI 0.84-1.23, p = .86). Exploratory analyses after the same adjustments suggested that a diagnosis of mood disorders was significantly associated with reduced mortality, which might be explained by the use of antidepressants.

Conclusions: These findings suggest that the increased risk of COVID-19-related mortality in individuals with psychiatric disorders hospitalized for COVID-19 might be explained by the greater number of medical conditions and the higher prevalence of obesity in this population and not by the underlying psychiatric disease.

Keywords: Antidepressants; COVID-19; Comorbidity; Mental disorders; Mood disorders; Mortality; Obesity; Psychiatric disorders; Risk of death; SARS-CoV-2.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Study cohort. Individuals can have more than one diagnosis of psychiatric disorder. Percentages for each psychiatric diagnosis category refer to the total number of patients with any diagnosis of psychiatric disorder (n = 857).
Figure 2
Figure 2
Number of patients hospitalized for COVID-19 with and without a diagnosis of psychiatric disorder (A), mortality rates by psychiatric diagnosis category (B) and by psychiatric diagnosis (C), and associations between a diagnosis of psychiatric disorder and mortality (D). Only psychiatric diagnoses with more than 20 patients are displayed in (C). In (D), model 1 was adjusted for age and sex; model 2 was adjusted for age, sex, hospital, current smoking, and medications according to compassionate use or as part of a clinical trial; and model 3 was adjusted for age, sex, hospital, current smoking, medications according to compassionate use or as part of a clinical trial, obesity, and number of medical conditions.
See this image and copyright information in PMC

References

    1. Yang H., Chen W., Hu Y., Chen Y., Zeng Y., Sun Y., et al. Pre-pandemic psychiatric disorders and risk of COVID-19: A UK Biobank cohort analysis. Lancet Healthy Longev. 2020;1:e69–e79. - PMC - PubMed
    1. Wang Q.Q., Kaelber D.C., Xu R., Volkow N.D. COVID-19 risk and outcomes in patients with substance use disorders: Analyses from electronic health records in the United States [published correction appears in Mol Psychiatry 2021; 26:40] Mol Psychiatry. 2021;26:30–39. - PMC - PubMed
    1. Wang Q., Xu R., Volkow N.D. Increased risk of COVID-19 infection and mortality in people with mental disorders: Analysis from electronic health records in the United States. World Psychiatry. 2021;20:124–130. - PMC - PubMed
    1. Nemani K., Li C., Olfson M., Blessing E.M., Razavian N., Chen J., et al. Association of psychiatric disorders with mortality among patients with COVID-19. JAMA Psychiatry. 2021;78:380–386. - PMC - PubMed
    1. Wan Y., Wu J., Ni L., Luo Q., Yuan C., Fan F., et al. Prognosis analysis of patients with mental disorders with COVID-19: A single-center retrospective study. Aging (Albany NY) 2020;12:11238–11244. - PMC - PubMed