Comorbidity patterns and mortality among hospitalized patients with psychiatric disorders and COVID-19

Abstract

Objectives: To examine the association between psychiatric and non-psychiatric comorbidity and 28-day mortality among patients with psychiatric disorders and COVID-19. Methods: Multicenter observational retrospective cohort study of adult patients with psychiatric disorders hospitalized with laboratory-confirmed COVID-19 at 36 Greater Paris university hospitals (January 2020-May 2021) (n=3,768). First, we searched for different subgroups of patients according to their psychiatric and non-psychiatric comorbidities through cluster analysis. Next, we compared 28-day all-cause mortality rates across the identified clusters, while taking into account sex, age, and the number of medical conditions. Results: We found five clusters of patients with distinct psychiatric and non-psychiatric comorbidity patterns. Twenty-eight-day mortality in the cluster of patients with mood disorders was significantly lower than in other clusters. There were no significant differences in mortality across other clusters. Conclusion: All psychiatric and non-psychiatric conditions may be associated with increased mortality in patients with psychiatric disorders and COVID-19. The lower risk of death among patients with mood disorders might be in line with the potential beneficial effect of certain antidepressants in COVID-19, but requires further research. These findings may help identify at-risk patients with psychiatric disorders who should benefit from vaccine booster prioritization and other prevention measures.

Keywords

• COVID-19
• psychiatric disorders
• comorbidity
• mortality
• clustering
• mood disorders