COVID-19 outbreak in a psychiatric hospital: what makes it worse?

Zoghbi, Marouan; Haddad, Chadia; Khansa, Wael; Karam, Elie G.; Chamoun, Angela; Hachem, Dory

doi:10.1186/s12991-022-00403-4

Cited by 4 publications

(4 citation statements)

References 45 publications

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“…Psychiatric residents are at increased risk of COVID-19 infection as they interact closely in group therapy and use shared spaces, such as bathrooms and dining rooms. They are more likely to get infected with COVID-19 than the general population [39].…”

Section: Discussionmentioning

confidence: 99%

The Epidemiological Analysis of COVID-19 Outbreaks in Nursing Homes during the Period of Omicron Variant Predominance

Tsai,

Chang,

Hsu

et al. 2023

Healthcare

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Background: The main purpose of this study was to evaluate the epidemic trend and risk factors associated with COVID-19 outbreaks in nursing homes during the period of Omicron variant predominance. Methods: The study analyzed the risk factors associated with SARS-CoV-2 infection and death among the 327 residents and 129 healthcare workers (HCWs) in three hospital-affiliated nursing homes through a multivariate Cox regression model. Results: The rates of receiving a COVID-19 booster dose were 70.3% for the residents and 93.0% for the healthcare workers (HCWs), respectively. A number of asymptomatic individuals, including 54 (16.5%) residents and 15 (11.6%) HCWs, were detected through mass screening surveillance tests. The COVID-19 infection rates during the outbreaks were 41.6% among residents and 48.1% among HCWs, respectively. The case fatality rate among residents was 10.3%. None of the HCWs were hospitalized or died. The multivariate Cox regression model showed that the risk of COVID-19 infection increased in males (HR 2.46; 95% CI 1.47–4.11; p = 0.001), Barthel index ≥ 61 (HR 1.93; 95% CI 1.18–3.17; p = 0.009), and dementia (HR 1.61; 95% CI 1.14–2.27; p = 0.007). The risk of COVID-19 death increased with pneumonia (HR 11.03; 95% CI 3.02–40.31; p < 0.001), hospitalization (HR 7.18; 95% CI 1.97–26.25; p = 0.003), and admission to an intensive care unit (HR 8.67; 95% CI 2.79–26.89; p < 0.001). Conclusions: This study highlighted the high infection rates with a substantial proportion of asymptomatic infections for both residents and HCWs, as well as a high case fatality rate for the residents among nursing homes during the Omicron epidemic period. We suggest implementing mass screening through regular surveillance testing as an effective strategy for early detection of COVID-19 and for preventing transmission during an epidemic period. Pneumonia is the primary risk associated with COVID-19 death. Early detection and prompt treatment of pneumonia for vulnerable residents in nursing homes are crucial to protect them from potential mortality.

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Section: Discussionmentioning

confidence: 99%

The Epidemiological Analysis of COVID-19 Outbreaks in Nursing Homes during the Period of Omicron Variant Predominance

Tsai,

Chang,

Hsu

et al. 2023

Healthcare

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“…In psychiatric hospitals, patients reside in closer proximity, interact more closely and frequently with nursing staff, and use more communal spaces such as the bathrooms and dining room. They also have higher rates of physical health comorbidities which increases the risk of COVID-19 infection and are associated with poorer outcomes if infected [ 15 , 16 ]. They may exhibit irrational behaviours, anger and impulsivity, and it may be difficult for them to adhere to infection control measures such as hand washing and mask-wearing [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

Psychological well-being of healthcare workers during COVID-19 in a mental health institution

Leung,

Lim,

Lim

et al. 2024

PLoS ONE

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Introduction This study examined the psychological wellbeing of Healthcare Workers (HCWs) during COVID-19 in a mental health setting, associations of psychosocial wellbeing with coping style, and ways that organisations can mitigate the psychosocial burden on HCWs. Methods Thirty-seven Mental HCWs (MHCWs) from infected and non-infected wards (control group), were recruited and assessed at three timepoints. Psychological wellbeing, perceived cohesion, and coping style (Brief-COPE) were assessed. Reports on individual coping and feedback on the organisation were collected through in-depth interview. Comparison between infected and non-infected wards, as well as comparison of psychosocial measures and perceived cohesion, across the three timepoints were made. As there were no significant changes in coping styles across the timepoints, Timepoint 1 (T1) coping style was used to correlate with the psychosocial measures across all timepoints. Thematic analysis was used for qualitative data. Results MHCWs from infected wards reported significantly higher levels of stress, χ2(1) = 6.74, p = 0.009, effect size: medium (ε2 = 0.198), and more severe sleep disturbance (PSQI), χ2(1) = 6.20, p = 0.013, effect size: medium (ε2 = 0.182), as compared to the control group at T2. They also engaged in more problem-focused coping (T2 and T3) and emotion-focused coping (T2). As expected, negative coping style was correlated with negative outcomes except problem-focused coping that was correlated with both negative (sleep disturbance and anxiety symptoms) and positive outcomes (wellbeing). Emotion-focused coping was moderately correlated (Tb = 0.348, p<0.017) with higher levels of wellbeing at T2. Thematic analyses revealed MHCWs felt supported by the responsiveness of the institution, emotional and informational support, and the availability from direct leaders, presence of team and hospital leaders on the ground, helped build trust and confidence in the leadership. Conclusions MHCWs experienced significantly higher levels of stress and sleep disturbance during COVID-19. The ways that organizations can offset the psychological burden of pandemics on MHCWs are discussed.

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“…Psychiatry wards are exposed to a higher risk of COVID‐19 outbreaks due to difficulties in controlling the spread of infection 1–3 . As part of infection control strategies, mandatory screening tests, such as polymerase chain reaction test (PCR test), and universal mask‐wearing have been suggested 4 .…”

Section: Introductionmentioning

confidence: 99%

“…Psychiatry wards are exposed to a higher risk of COVID‐19 outbreaks due to difficulties in controlling the spread of infection. 1 , 2 , 3 As part of infection control strategies, mandatory screening tests, such as polymerase chain reaction test (PCR test), and universal mask‐wearing have been suggested. 4 On the other hand, the implementation of those control strategies has recently decreased due to milder symptoms associated with the omicron variant.…”

Section: Introductionmentioning

confidence: 99%

Caution to psychiatry ward: COVID‐19 pneumonia can manifest weeks or months after testing positive with a PCR test in individuals on preexisting immune‐suppressing medication

Nakano,

Funayama,

Wakisaka

et al. 2023

PCN Reports

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BackgroundSome patients are reported to develop depression immediately after COVID‐19 infection. Typically, hospitalization is arranged a week to 10 days after symptom onset to avoid outbreak in the psychiatric ward when infectivity is almost eliminated. However, in patients on immunosuppressive drugs, infection is known to persist beyond the 10th day after testing positive with a polymerase chain reaction (PCR) test.Case PresentationWe present a patient with follicular lymphoma who was receiving immune‐suppressing medication and contracted a COVID‐19 infection; she developed severe depression and eventually required hospitalization 10 days after symptom onset or 5 days after the COVID‐19 infection‐related symptoms disappeared. Although the patient did not exhibit any symptom of pneumonia upon admission, she developed COVID‐19 pneumonia 3 weeks after the initial positive test. She received intravenous infusion of the antiviral drug remdesivir, which led to the improvement of pneumonia, and she was discharged on day 32 from testing COVID‐19 positive. However, COVID‐19 pneumonia recurred on days 64 and 74.ConclusionThis is the first report of COVID‐19 pneumonia developing in a psychiatric ward in a patient on immunosuppressive drugs, weeks to months after testing positive with a PCR test. When patients with compromised immune function, such as those on immunosuppressant medication or those with human immunodeficiency virus disease, are admitted to a psychiatric ward, careful monitoring of the risk of recurrence and sufficient consideration for infection control measures are necessary to avoid outbreaks.

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COVID-19 outbreak in a psychiatric hospital: what makes it worse?

Cited by 4 publications

References 45 publications

The Epidemiological Analysis of COVID-19 Outbreaks in Nursing Homes during the Period of Omicron Variant Predominance

The Epidemiological Analysis of COVID-19 Outbreaks in Nursing Homes during the Period of Omicron Variant Predominance

Psychological well-being of healthcare workers during COVID-19 in a mental health institution

Caution to psychiatry ward: COVID‐19 pneumonia can manifest weeks or months after testing positive with a PCR test in individuals on preexisting immune‐suppressing medication

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