Epidemiology, Infection Prevention, Testing Data, and Clinical Outcomes of COVID-19 on Five Inpatient Psychiatric Units in a large Academic Medical Center

Abstract

Inpatient psychiatric facilities can face significant challenges in containing infectious outbreaks during the COVID-19 pandemic. The main objective of this study was to characterize the epidemiology, testing data, and containment protocols of COVID-19 in a large academic medical center during the height of the COVID-19 outbreak. A retrospective cohort analysis was conducted on hospitalized individuals on five inpatient psychiatric units from March 1 st to July 8 th , 2020. Demographic data collected include age, race, gender, ethnicity, diagnosis, and admission status (one or multiple admissions). In addition, a Gantt chart was used to assess outbreak data and timelines for one unit. Testing data was collected for patients admitted to inpatient psychiatric units, emergency room visits, and employees. 964 individuals were hospitalized psychiatrically. The study population included ethnically diverse patients with various mental illnesses. We also describe infection prevention strategies, screening, and triage protocols utilized to safely continue patient flow during and beyond the study period with a low patient and employee infection rate. In summary, our study suggests that early implementation of triage, screening, extensive testing, and unit-specific interventions can help prevent and contain the spread of COVID-19 in inpatient psychiatric units and help facilitate safe delivery of care during a pandemic.

Shifts in inpatient psychiatry utilization patterns at a U.S. Academic Medical Center during the COVID-19 pandemic

“…Our findings suggest that admission volume was heavily impacted by structural changes in response to COVID-19 infection prevention standards, and not fully a function of reductions due to lessened demand. For example, we developed a COVID+ inpatient psychiatry unit for 4 weeks that impacted inpatient bed volumes (decreased number of beds on one unit) ( Li et al., 2021 ; Luming Li et al., 2020 ). In addition, we made accommodations to temporarily reduce inpatient volume capacity to meet social distancing requirements and to quarantine patients.…”

Prevalence of COVID-19 and Psychotropic Drug Treatment in Psychiatric In-patients in Germany in 2020: Results from a Nationwide Pilot Survey

“…Similar findings have been reported during other Coronavirus infections 3 . Importantly, further studies showed an increased risk for a SARS-CoV-2 infection and a more severe course of COVID-19 in psychiatric patients 11 21 22 25 , although comorbidity may have an important role therein. Comorbid medical conditions are frequent, especially in severe mental disorders, leading to reduced life expectancy; if they are accounted for, increased COVID-19 mortality rates in mental disorders were no longer observed 57 .…”

“…Vice versa, Taquet et al 11 reported that patients suffering from a mental illness (particularly mood disorders, anxiety disorders, or psychotic disorders) showed an increased risk for COVID-19. Further, patients with mental disorders have been reported to have a more severe outcome of COVID-19, including admission to an intensive care unit and death, as evidenced by numerous studies 19 20 21 22 23 24 21 25 26 and corroborated by a meta-analysis 20 . The same seems to hold true for a pre-existing substance abuse disorder 27 .…”

Exploring the Gantt chart as a tool to highlight double report in case series published during the first wave of the COVID-19 pandemic

“…The Gantt chart can be used in several situations, each with a particular view, with the intention to evaluate “temporal dependencies” [ 38 ]. It was used to tell the “historiophoty” of a university department [ 39 ], and, more recently, to describe the clinical course of COVID-19 cases across time [ 40 ], and to describe cases of COVID-19 in some psychiatric facilities [ 41 ].…”