The impact of preexisting psychiatric disorders and antidepressant use on COVID-19 related outcomes: a multicenter study

Abstract

Pre-existing mental disorders are linked to COVID-19-related outcomes. However, the findings are inconsistent and a thorough analysis of a broader spectrum of outcomes such as COVID-19 infection severity, morbidity, and mortality is required. We investigated whether the presence of psychiatric diagnoses and/or the use of antidepressants influenced the severity of the outcome of COVID-19. This retrospective cohort study evaluated electronic health records from the INSIGHT Clinical Research Network in 116,498 individuals who were diagnosed with COVID-19 between March 1, 2020, and February 23, 2021. We examined hospitalization, intubation/mechanical ventilation, acute kidney failure, severe sepsis, and death as COVID-19-related outcomes. After using propensity score matching to control for demographics and medical comorbidities, we used contingency tables to assess whether patients with (1) a history of psychiatric disorders were at higher risk of more severe COVID-19-related outcomes and (2) if use of antidepressants decreased the risk of more severe COVID-19 infection. Pre-existing psychiatric disorders were associated with an increased risk for hospitalization, and subsequent outcomes such as acute kidney failure and severe sepsis, including an increased risk of death in patients with schizophrenia spectrum disorders or bipolar disorders. The use of antidepressants was associated with significantly reduced risk of sepsis ( p = 0.033), death ( p = 0.026). Psychiatric disorder diagnosis prior to a COVID-19-related healthcare encounter increased the risk of more severe COVID-19-related outcomes as well as subsequent health complications. However, there are indications that the use of antidepressants might decrease this risk. This may have significant implications for the treatment and prognosis of patients with COVID-19.

Abstinence duration and psychopathology among addiction outpatients during 18 months of COVID-19

“…Patients with pre-existing mental disorders have been identified as an at-risk group for adverse outcomes both physical and emotional ( 50 , 51 ). In our current study, patients with psychiatric comorbidity achieved shorter duration of abstinence.…”

Association of mental disorders with sepsis: a bidirectional Mendelian randomization study

“…Previous studies have indicated that mental disorders are the primary risk factors related to the advancement of sepsis. For instance, retrospective multicenter research revealed that patients previously diagnosed with mental illnesses, including MDD, attention deficit hyperactivity disorder (ADHD), schizophrenia (SCZ), bipolar disorder (BD) and panic disorder (PD), possess a greater likelihood of severe sepsis and related death (7). However, a nationwide cohort study from France suggested that septic patients with BD, MDD, and SCZ, have lower 90-day case fatality rates than other individuals (8).…”