Psychosis and substance abuse increase the COVID-19 mortality risk
Ana Catalán, Clàudia Aymerich, Amaia Bilbao, Borja Pedruzo, José Luis Rey Pérez, Nerea Aranguren, Gonzalo Salazar de Pablo, Emily Hedges, Patxi Gil, Rafael Segarra, Ana González‐Pinto, Aranzazu Fernández‐Rivas, Lucía Inchausti, Philip McGuire, Paolo Fusar‐Poli, Miguel Ángel González Torres
Abstract
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.