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. 2023 Jul;53(9):4236-4244.
doi: 10.1017/S0033291722000976. Epub 2022 Apr 12.

Psychosis and substance abuse increase the COVID-19 mortality risk

Ana Catalan  1   2   3   4 , Claudia Aymerich  1 , Amaia Bilbao  5   6   7 , Borja Pedruzo  1 , José Luis Pérez  1 , Nerea Aranguren  8 , Gonzalo Salazar de Pablo  9   10 , Emily Hedges  4 , Patxi Gil  2   11 , Rafael Segarra  2   3   12 , Ana González-Pinto  3   13 , Aranzazu Fernández-Rivas  1   2   3 , Lucía Inchausti  1   2   3 , Philip McGuire  4   14   15 , Paolo Fusar-Poli  4   7   15 , Miguel Ángel González-Torres  1   2   3
Affiliations

Psychosis and substance abuse increase the COVID-19 mortality risk

Ana Catalan et al. Psychol Med. 2023 Jul.

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic has been a global challenge. High mortality rates have been reported in some risk groups, including patients with pre-existing mental disorders.

Methods: We used electronic health records to retrospectively identify people infected due to COVID-19 (between March 2020 and March 2021) in the three territories of the Basque Country. COVID-19 cases were defined as individuals who had tested positive on a reverse transcription-polymerase chain reaction (PCR) test. Univariate and multivariate logistic regression models and multilevel analyses with generalized estimated equations were used to determine factors associated with COVID-19-related mortality and hospital admission.

Results: The COVID-19 mortality rate was increased for patients with psychotic disorders [odds ratio (OR) adjusted: 1.45, 95% confidence interval (CI) (1.09-1.94), p = 0.0114] and patients with substance abuse [OR adjusted: 1.88, 95% CI (1.13-3.14, p < 0.0152)]. The mortality rate was lower for patients with affective disorders [OR adjusted: 0.80, 95% CI (0.61-0.99), p = 0.0407]. Hospital admission rates due to COVID-19 were higher in psychosis [OR adjusted: 2.90, 95% CI (2.36-3.56), p < 0.0001] and anxiety disorder groups [OR adjusted: 1.54, 95% CI (1.37-1.72), p < 0.0001]. Among admitted patients, COVID-19 mortality rate was decreased for those with affective disorders rate [OR adjusted: 0.72, 95% CI (0.55-0.95), p = 0.0194].

Conclusions: COVID-19-related mortality and hospitalizations rates were higher for patients with a pre-existing psychotic disorder.

Keywords: COVID-19; hospitalization; mental disorders; mortality; psychosis.

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Conflict of interest statement

Dr Catalan reports personal fees from Janssen-Cilag and grants from the Carlos III Health Institute outside the submitted work. Dr Salazar de Pablo reports grants from Fundación Alicia Koplowitz and personal fees from Janssen-Cilag outside the submitted work. Professor Fusar-Poli reports research fees from Lundbeck and honoraria from Lundbeck, Angelini, Menarini, and Boehringer Ingelheim outside the submitted work. No other disclosures were reported. Professor González-Torres reports grants from the Carlos III Health Institute outside the submitted work. Dr Gonzalez-Pinto has received grants and served as consultant, advisor or CME speaker for the following entities: Janssen-Cilag, Lundbeck, Otsuka, Pfizer, Sanofi-Aventis, Alter, Angelini, Exeltis, Novartis, Takeda, the Spanish Ministry of Science and Innovation (CIBERSAM), the Ministry of Science (Carlos III Institute), the Basque Government, and the European Framework Program of Research. Dr Segarra reports personal fees from Janssen-Cilag, Lundbeck, Otsuka, Angelini, and grants from the Carlos III Health Institute and the Basque Government outside the submitted work.

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