BACKGROUND
The COVID-19 pandemic has created unprecedented challenges for health care systems globally. The identification of risk factors is crucial when optimizing medical resources for specific vulnerable population groups such as patients with mental disorders, who are specially at risk of poor COVID-19 outcomes.
OBJECTIVE
We aimed at evaluating the associated risk of hospitalization and mortality in infected individuals based on the presence of specific mental disorders.
METHODS
Retrospective cohort study including all individuals with confirmed infection by SARS-CoV-2 from the PRECOVID Study (Aragon, Spain). Mental health illness was defined as the presence of schizophrenia and other psychotic disorders, anxiety, cognitive disorders, depression and mood disorders, substance abuse, and personality and eating disorders. Multivariable logistic regression models were used to examine the likelihood of 30-day all-cause mortality and COVID-19 related hospitalization based on baseline demographic and clinical variables, including the presence of specific mental conditions, by gender.
RESULTS
In this cohort study including 144,957 individuals with confirmed COVID-19 from the PRECOVID Study (Aragon, Spain), anxiety was the most frequent diagnosis. However, some differences were observed by sex: substance abuse, personality disorders and schizophrenia were more frequently diagnosed in men, while eating disorders, depression and mood, anxiety and cognitive disorders were more common among women. Of the total number of patients with mental illness and COVID-19 infection, 4.7% died and 13.8% were hospitalized during the follow-up period. The presence of mental illness, specifically schizophrenia spectrum and cognitive disorders in men, and depression and mood disorders, substance abuse, anxiety and cognitive and personality disorders in women, increased the risk of mortality or hospitalization after COVID-19, in addition to other well-known risk factors such as age, morbidity and treatment burden.
CONCLUSIONS
Identifying vulnerable patient profiles at risk of serious outcomes after COVID-19 based on their mental health status will be crucial to improve their access to the healthcare system and implement targeted public health prevention measures.