Association of a Prior Psychiatric Diagnosis With Mortality Among Hospitalized Patients With Coronavirus Disease 2019 (COVID-19) Infection

Source:

Li L, Li F, Fortunati F, Krystal JH. Association of a Prior Psychiatric Diagnosis With Mortality Among Hospitalized Patients With Coronavirus Disease 2019 (COVID-19) Infection. JAMA Netw Open. 2020;3(9):e2023282. doi:10.1001/jamanetworkopen.2020.23282

Discussion

This is the first study, to our knowledge, that characterizes the association of psychiatric diagnosis with COVID-19–related mortality. 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 findings: individuals with concurrent psychiatric and medical diagnoses had poorer outcomes and higher mortality.

It is unclear why psychiatric illness predisposes to COVID-19–related mortality. Psychiatric symptoms may arise as a marker of systemic pathophysiologic processes, such as inflammation, that may, in turn, predispose to mortality. Similarly, psychiatric disorders may augment systemic inflammation and compromise the function of the immune system, while psychotropic medications may also be associated with to mortality risk.

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 (patient with active, in-remission, or recovered psychiatric disorder). The data also do not include COVID-19 treatment information.