Prior psychiatric diagnosis associated with mortality for hospitalized COVID-19 patients

A prior psychiatric diagnosis may be associated with mortality among hospitalized patients with the novel coronavirus, according to a new study published in JAMA Network Open.

The cohort study was conducted at the Yale New Haven Health System using data obtained from its electronic medical record, which included all encounters of hospitalized COVID-19–positive patients between February 15 and April 25, 2020, and followed up to May 27, 2020, for mortality. The analysis compared the survival rates using the log-rank test, and did include assessing the association of pretreatment risk factors, including age, sex, race and ethnicity, medical comorbidities, and hospital location, according to the study.

A total of 1,685 patients were hospitalized with COVID-19 during the study period, the paper said, with a mean age of 65.2 years old. Of the patients, 28 percent received psychiatric diagnoses prior to hospitalization.

The study found patients with psychiatric diagnoses were significantly older and more likely to be female, white, and non-Hispanic, and have medical comorbidities, such as cancer, diabetes, or congestive heart failure. Overall, 318 patients from the cohort died.

The researchers found patients with a psychiatric diagnosis had a higher mortality rate compared with those with no psychiatric diagnosis, with 35.7 percent versus 14.7 percent of two-week mortality and 40.9 percent versus 22.2 percent of three-week mortality rate. The median follow-up time was eight days, the study said.

According to the researchers, the primary finding is that patients with a prior psychiatric diagnosis while hospitalized for COVID-19 had a higher mortality rate compared those without a psychiatric condition. The finding is similar to previous studies, which have found individuals with concurrent psychiatric and medical diagnoses had poorer outcomes and higher mortality.

The limitations to the study include the fact that those individuals not hospitalized for COVID-19 or who died outside the hospital were not used in the analysis. In addition, diagnosis codes were used to assess for any psychiatric diagnosis, without accounting for the status of psychiatric treatment. The data also do not include COVID-19 treatment information.

It is unclear why psychiatric illness predisposes to COVID-19–related mortality, the authors said.

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