COVID-19 risk, course and outcome in people with mental disorders: a systematic review and meta-analyses
Abstract Aims It has been suggested that people with mental disorders have an elevated risk to acquire severe acute respiratory syndrome coronavirus 2 and to be disproportionally affected by coronavirus disease 19 (COVID-19) once infected. We aimed to analyse the COVID-19 infection rate, course and...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2023-01-01
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| Series: | Epidemiology and Psychiatric Sciences |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2045796023000719/type/journal_article |
| _version_ | 1797655365992579072 |
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| author | Patricio Molero Gabriel Reina Jan Dirk Blom Miguel Ángel Martínez-González Aischa Reinken E. Ronald de Kloet Marc L. Molendijk |
| author_facet | Patricio Molero Gabriel Reina Jan Dirk Blom Miguel Ángel Martínez-González Aischa Reinken E. Ronald de Kloet Marc L. Molendijk |
| author_sort | Patricio Molero |
| collection | DOAJ |
| description | Abstract
Aims
It has been suggested that people with mental disorders have an elevated risk to acquire severe acute respiratory syndrome coronavirus 2 and to be disproportionally affected by coronavirus disease 19 (COVID-19) once infected. We aimed to analyse the COVID-19 infection rate, course and outcome, including mortality and long COVID, in people with anxiety, depressive, neurodevelopmental, schizophrenia spectrum and substance use disorders relative to control subjects without these disorders.
Methods
This study constitutes a preregistered systematic review and random-effects frequentist and Bayesian meta-analyses. Major databases were searched up until 27 June 2023.
Results
Eighty-one original articles were included reporting 304 cross-sectional and prospective effect size estimates (median n per effect-size = 114837) regarding associations of interest. Infection risk was not significantly increased for any mental disorder that we investigated relative to samples of people without these disorders. The course of COVID-19, however, is relatively severe, and long COVID and COVID-19-related hospitalization are more likely in all patient samples that we investigated. The odds of dying from COVID-19 were high in people with most types of mental disorders, except for those with anxiety and neurodevelopmental disorders relative to non-patient samples (pooled ORs range, 1.26–2.57). Bayesian analyses confirmed the findings from the frequentist approach and complemented them with estimates of the strength of evidence.
Conclusions
Once infected, people with pre-existing mental disorders are at an elevated risk for a severe COVID-19 course and outcome, including long COVID and mortality, relative to people without pre-existing mental disorders, despite an infection risk not significantly increased.
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| first_indexed | 2024-03-11T17:13:13Z |
| format | Article |
| id | doaj.art-44573c2504044045960a9901944fb681 |
| institution | Directory Open Access Journal |
| issn | 2045-7960 2045-7979 |
| language | English |
| last_indexed | 2024-03-11T17:13:13Z |
| publishDate | 2023-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Epidemiology and Psychiatric Sciences |
| spelling | doaj.art-44573c2504044045960a9901944fb6812023-10-20T05:28:29ZengCambridge University PressEpidemiology and Psychiatric Sciences2045-79602045-79792023-01-013210.1017/S2045796023000719COVID-19 risk, course and outcome in people with mental disorders: a systematic review and meta-analysesPatricio Molero0https://orcid.org/0000-0002-9287-9635Gabriel Reina1https://orcid.org/0000-0003-4079-9753Jan Dirk Blom2Miguel Ángel Martínez-González3Aischa Reinken4E. Ronald de Kloet5Marc L. Molendijk6https://orcid.org/0000-0003-2819-0988Department of Psychiatry and Clinical Psychology, Clínica Universidad de Navarra, Pamplona, Spain Navarra Institute for Health Research (IdiSNA), Pamplona, SpainNavarra Institute for Health Research (IdiSNA), Pamplona, Spain Department of Microbiology, Clínica Universidad de Navarra, Pamplona, SpainInstitute of Psychology, Department of Clinical Psychology, Leiden University, Leiden, The Netherlands Outpatient Clinic for Uncommon Psychiatric Syndromes, Parnassia Psychiatric Institute, The Hague, The Netherlands Department of Psychiatry, University Medical Centre Groningen, University of Groningen, Groningen, The NetherlandsNavarra Institute for Health Research (IdiSNA), Pamplona, Spain Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain CIBER-OBN, Instituto de Salud Carlos III, Madrid, Spain Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USAInstitute of Psychology, Department of Clinical Psychology, Leiden University, Leiden, The NetherlandsDivision of Endocrinology, Department of Internal Medicine, Leiden University Medical Center, Leiden, The NetherlandsInstitute of Psychology, Department of Clinical Psychology, Leiden University, Leiden, The Netherlands Leiden Institute for Brain and Cognition, Leiden University Medical Center, Leiden, The NetherlandsAbstract Aims It has been suggested that people with mental disorders have an elevated risk to acquire severe acute respiratory syndrome coronavirus 2 and to be disproportionally affected by coronavirus disease 19 (COVID-19) once infected. We aimed to analyse the COVID-19 infection rate, course and outcome, including mortality and long COVID, in people with anxiety, depressive, neurodevelopmental, schizophrenia spectrum and substance use disorders relative to control subjects without these disorders. Methods This study constitutes a preregistered systematic review and random-effects frequentist and Bayesian meta-analyses. Major databases were searched up until 27 June 2023. Results Eighty-one original articles were included reporting 304 cross-sectional and prospective effect size estimates (median n per effect-size = 114837) regarding associations of interest. Infection risk was not significantly increased for any mental disorder that we investigated relative to samples of people without these disorders. The course of COVID-19, however, is relatively severe, and long COVID and COVID-19-related hospitalization are more likely in all patient samples that we investigated. The odds of dying from COVID-19 were high in people with most types of mental disorders, except for those with anxiety and neurodevelopmental disorders relative to non-patient samples (pooled ORs range, 1.26–2.57). Bayesian analyses confirmed the findings from the frequentist approach and complemented them with estimates of the strength of evidence. Conclusions Once infected, people with pre-existing mental disorders are at an elevated risk for a severe COVID-19 course and outcome, including long COVID and mortality, relative to people without pre-existing mental disorders, despite an infection risk not significantly increased. https://www.cambridge.org/core/product/identifier/S2045796023000719/type/journal_articlecorona virus diseaseCOVID-19disease courseinfection risklong COVIDmental disorderssubstance use disorders |
| spellingShingle | Patricio Molero Gabriel Reina Jan Dirk Blom Miguel Ángel Martínez-González Aischa Reinken E. Ronald de Kloet Marc L. Molendijk COVID-19 risk, course and outcome in people with mental disorders: a systematic review and meta-analyses Epidemiology and Psychiatric Sciences corona virus disease COVID-19 disease course infection risk long COVID mental disorders substance use disorders |
| title | COVID-19 risk, course and outcome in people with mental disorders: a systematic review and meta-analyses |
| title_full | COVID-19 risk, course and outcome in people with mental disorders: a systematic review and meta-analyses |
| title_fullStr | COVID-19 risk, course and outcome in people with mental disorders: a systematic review and meta-analyses |
| title_full_unstemmed | COVID-19 risk, course and outcome in people with mental disorders: a systematic review and meta-analyses |
| title_short | COVID-19 risk, course and outcome in people with mental disorders: a systematic review and meta-analyses |
| title_sort | covid 19 risk course and outcome in people with mental disorders a systematic review and meta analyses |
| topic | corona virus disease COVID-19 disease course infection risk long COVID mental disorders substance use disorders |
| url | https://www.cambridge.org/core/product/identifier/S2045796023000719/type/journal_article |
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