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. 2022 Aug 16;65(1):e47.
doi: 10.1192/j.eurpsy.2022.2307.

Joint European policy on the COVID-19 risks for people with mental disorders: An umbrella review and evidence- and consensus-based recommendations for mental and public health

Benedetta Vai  1   2 , Mario Gennaro Mazza  1   2 , Casanova Dias Marisa  3   4 , Julian Beezhold  5   6 , Hilkka Kärkkäinen  7 , John Saunders  8 , Jerzy Samochowiec  9 , Francesco Benedetti  1   2 , Marion Leboyer  10   11 , Paolo Fusar-Poli  12   13 , Livia De Picker  14   15
Affiliations

Joint European policy on the COVID-19 risks for people with mental disorders: An umbrella review and evidence- and consensus-based recommendations for mental and public health

Benedetta Vai et al. Eur Psychiatry. .

Abstract

As COVID-19 becomes endemic, identifying vulnerable population groups for severe infection outcomes and defining rapid and effective preventive and therapeutic strategies remains a public health priority. We performed an umbrella review, including comprehensive studies (meta-analyses and systematic reviews) investigating COVID-19 risk for infection, hospitalization, intensive care unit (ICU) admission, and mortality in people with psychiatric disorders, and outlined evidence- and consensus-based recommendations for overcoming potential barriers that psychiatric patients may experience in preventing and managing COVID-19, and defining optimal therapeutic options and current research priorities in psychiatry. We searched Web of Science, PubMed, and Ovid/PsycINFO databases up to 17 January 2022 for the umbrella review. We synthesized evidence, extracting when available pooled odd ratio estimates for the categories "any mental disorder" and "severe mental disorders." The quality of each study was assessed using the AMSTAR-2 approach and ranking evidence quality. We identified four systematic review/meta-analysis combinations, one meta-analysis, and three systematic reviews, each including up to 28 original studies. Although we rated the quality of studies from moderate to low and the evidence ranged from highly suggestive to non-significant, we found consistent evidence that people with mental illness are at increased risk of COVID-19 infection, hospitalization, and most importantly mortality, but not of ICU admission. The risk and the burden of COVID-19 in people with mental disorders, in particular those with severe mental illness, can no longer be ignored but demands urgent targeted and persistent action. Twenty-two recommendations are proposed to facilitate this process.

Keywords: COVID-19; mental health; psychiatry; recommendations; umbrella review.

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Figures

Figure 1.
Figure 1.
PRISMA flow chart of included studies
See this image and copyright information in PMC

References

    1. Nemani K, Li C, Olfson M, Blessing EM, Razavian N, Chen J, et al. Association of psychiatric disorders with mortality among patients with COVID-19. JAMA Psychiatry. 2021;78:380–86. - PMC - PubMed
    1. De Picker LJ, Yolken R, Benedetti F, Borsini A, Branchi I, Fusar-Poli P, et al. Viewpoint|European COVID-19 exit strategy for people with severe mental disorders: too little, but not yet too late. Brain Behav Immun. 2021;94:15–7. - PMC - PubMed
    1. Mazereel V, Van Assche K, Detraux J, De Hert M. COVID-19 vaccination for people with severe mental illness: why, what, and how? Lancet Psychiatry 2021;8:444–50. - PMC - PubMed
    1. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. - PMC - PubMed
    1. Shea BJ, Reeves BC, Wells G, Thuku M, Hamel C, Moran J, et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ. 2017;358:j4008. - PMC - PubMed

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