Biological Psychiatry Global Open Science (Jan 2023)

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

  • Nicolas Hoertel,
  • Marina Sánchez-Rico,
  • Pedro de la Muela,
  • Miriam Abellán,
  • Carlos Blanco,
  • Marion Leboyer,
  • Céline Cougoule,
  • Erich Gulbins,
  • Johannes Kornhuber,
  • Alexander Carpinteiro,
  • Katrin Anne Becker,
  • Raphaël Vernet,
  • Nathanaël Beeker,
  • Antoine Neuraz,
  • Jesús M. Alvarado,
  • Juan José Herrera-Morueco,
  • Guillaume Airagnes,
  • Cédric Lemogne,
  • Frédéric Limosin,
  • Pierre-Yves Ancel,
  • Alain Bauchet,
  • Nathanaël Beeker,
  • Vincent Benoit,
  • Mélodie Bernaux,
  • Ali Bellamine,
  • Romain Bey,
  • Aurélie Bourmaud,
  • Stéphane Breant,
  • Anita Burgun,
  • Fabrice Carrat,
  • Charlotte Caucheteux,
  • Julien Champ,
  • Sylvie Cormont,
  • Christel Daniel,
  • Julien Dubiel,
  • Catherine Ducloas,
  • Loic Esteve,
  • Marie Frank,
  • Nicolas Garcelon,
  • Alexandre Gramfort,
  • Nicolas Griffon,
  • Olivier Grisel,
  • Martin Guilbaud,
  • Claire Hassen-Khodja,
  • François Hemery,
  • Martin Hilka,
  • Anne Sophie Jannot,
  • Jerome Lambert,
  • Richard Layese,
  • Judith Leblanc,
  • Léo Lebouter,
  • Guillaume Lemaitre,
  • Damien Leprovost,
  • Ivan Lerner,
  • Kankoe Levi Sallah,
  • Aurélien Maire,
  • Marie-France Mamzer,
  • Patricia Martel,
  • Arthur Mensch,
  • Thomas Moreau,
  • Antoine Neuraz,
  • Nina Orlova,
  • Nicolas Paris,
  • Bastien Rance,
  • Hélène Ravera,
  • Antoine Rozes,
  • Elisa Salamanca,
  • Arnaud Sandrin,
  • Patricia Serre,
  • Xavier Tannier,
  • Jean-Marc Treluyer,
  • Damien Van Gysel,
  • Gaël Varoquaux,
  • Jill Jen Vie,
  • Maxime Wack,
  • Perceval Wajsburt,
  • Demian Wassermann,
  • Eric Zapletal

Journal volume & issue
Vol. 3, no. 1
pp. 56 – 67

Abstract

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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.

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