Psychiatric disorders among hospitalized patients deceased with COVID-19 in Italy
Background: there is concern about the increased risk for SARS-CoV-2 infection, COVID-19 severe outcomes and disparity of care among patients with a psychiatric disorder (PD). Based on the Italian COVID-19 death surveillance, which collects data from all the hospitals throughout the country, we aime...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-05-01
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| Series: | EClinicalMedicine |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589537021001346 |
| _version_ | 1831681584151920640 |
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| author | Ilaria Lega Lorenza Nisticò Luigi Palmieri Emanuele Caroppo Cinzia Lo Noce Chiara Donfrancesco Nicola Vanacore Maria Luisa Scattoni Angelo Picardi Antonella Gigantesco Silvio Brusaferro Graziano Onder |
| author_facet | Ilaria Lega Lorenza Nisticò Luigi Palmieri Emanuele Caroppo Cinzia Lo Noce Chiara Donfrancesco Nicola Vanacore Maria Luisa Scattoni Angelo Picardi Antonella Gigantesco Silvio Brusaferro Graziano Onder |
| author_sort | Ilaria Lega |
| collection | DOAJ |
| description | Background: there is concern about the increased risk for SARS-CoV-2 infection, COVID-19 severe outcomes and disparity of care among patients with a psychiatric disorder (PD). Based on the Italian COVID-19 death surveillance, which collects data from all the hospitals throughout the country, we aimed to describe clinical features and care pathway of patients dying with COVID-19 and a preceding diagnosis of a PD. Methods: in this cross-sectional study, the characteristics of a representative sample of patients, who have died with COVID-19 in Italian hospitals between February 21st and August 3rd 2020, were drawn from medical charts, described and analysed by multinomial logistic regression according to the recorded psychiatric diagnosis: no PD, severe PD (SPD) (i.e. schizophrenia and other psychotic disorders, bipolar and related disorders), common mental disorder (CMD) (i.e. depression without psychotic features, anxiety disorders). Findings: the 4020 COVID-19 deaths included in the study took place in 365 hospitals across Italy. Out of the 4020 deceased patients, 84 (2•1%) had a previous SPD, 177 (4.4%) a CMD. The mean age at death was 78.0 (95%CI 77.6–78.3) years among patients without a PD, 71.8 (95%CI 69.3–72.0) among those with an SPD, 79.5 (95%CI 78.0–81.1) in individuals with a CMD. 2253 (61.2%) patients without a PD, 62 (73.8%) with an SPD, and 136 (78.2%) with a CMD were diagnosed with three or more non-psychiatric comorbidities.When we adjusted for clinically relevant variables, including hospital of death, we found that SPD patients died at a younger age than those without a PD (adjusted OR per 1 year increment 0.96; 95% CI 0.94–0.98). Women were significantly more represented among CMD patients compared to patients without previous psychiatric history (aOR 1.56; 95% CI 1.05–2.32). Hospital admission from long-term care facilities (LTCFs) was strongly associated with having an SPD (aOR 9.02; 95% CI 4.99–16.3) or a CMD (aOR 2.09; 95% CI 1.19–3.66). Comorbidity burden, fever, admission to intensive care and time from symptoms’ onset to nasopharyngeal swab did not result significantly associated with an SPD or with a CMD in comparison to those without any PD. Interpretation: even where equal treatment is in place, the vulnerability of patients with a PD may reduce their chance of recovering from COVID-19. The promotion of personalised therapeutic projects aimed at including people with PD in the community rather than in non-psychiatric LTCFs should be prioritised. |
| first_indexed | 2024-12-20T06:00:11Z |
| format | Article |
| id | doaj.art-71bd16990380461880522b734465e43f |
| institution | Directory Open Access Journal |
| issn | 2589-5370 |
| language | English |
| last_indexed | 2024-12-20T06:00:11Z |
| publishDate | 2021-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EClinicalMedicine |
| spelling | doaj.art-71bd16990380461880522b734465e43f2022-12-21T19:50:55ZengElsevierEClinicalMedicine2589-53702021-05-0135100854Psychiatric disorders among hospitalized patients deceased with COVID-19 in ItalyIlaria Lega0Lorenza Nisticò1Luigi Palmieri2Emanuele Caroppo3Cinzia Lo Noce4Chiara Donfrancesco5Nicola Vanacore6Maria Luisa Scattoni7Angelo Picardi8Antonella Gigantesco9Silvio Brusaferro10Graziano Onder11National Centre for Disease Prevention and Health Promotion, Istituto Superiore di Sanità, Viale Regina Elena, Rome 299, Italy; Corresponding author.Centre for Behavioural Sciences and Mental Health, Istituto Superiore di Sanità, Viale Regina Elena, Rome 299, ItalyDepartment of Cardiovascular, Endocrine-metabolic Diseases and Aging, Istituto Superiore di Sanità, Viale Regina Elena, Rome 299, ItalyDepartment of Mental Health, Roma 2 Local Health Unit, Via Maria Brighenti, 23, Rome, ItalyDepartment of Cardiovascular, Endocrine-metabolic Diseases and Aging, Istituto Superiore di Sanità, Viale Regina Elena, Rome 299, ItalyDepartment of Cardiovascular, Endocrine-metabolic Diseases and Aging, Istituto Superiore di Sanità, Viale Regina Elena, Rome 299, ItalyNational Centre for Disease Prevention and Health Promotion, Istituto Superiore di Sanità, Viale Regina Elena, Rome 299, ItalyResearch Coordination and Support Service, Istituto Superiore di Sanità, Viale Regina Elena, Rome 299, ItalyCentre for Behavioural Sciences and Mental Health, Istituto Superiore di Sanità, Viale Regina Elena, Rome 299, ItalyCentre for Behavioural Sciences and Mental Health, Istituto Superiore di Sanità, Viale Regina Elena, Rome 299, ItalyOffice of the President, Istituto Superiore di Sanità, Viale Regina Elena, Rome 299, ItalyDepartment of Cardiovascular, Endocrine-metabolic Diseases and Aging, Istituto Superiore di Sanità, Viale Regina Elena, Rome 299, ItalyBackground: there is concern about the increased risk for SARS-CoV-2 infection, COVID-19 severe outcomes and disparity of care among patients with a psychiatric disorder (PD). Based on the Italian COVID-19 death surveillance, which collects data from all the hospitals throughout the country, we aimed to describe clinical features and care pathway of patients dying with COVID-19 and a preceding diagnosis of a PD. Methods: in this cross-sectional study, the characteristics of a representative sample of patients, who have died with COVID-19 in Italian hospitals between February 21st and August 3rd 2020, were drawn from medical charts, described and analysed by multinomial logistic regression according to the recorded psychiatric diagnosis: no PD, severe PD (SPD) (i.e. schizophrenia and other psychotic disorders, bipolar and related disorders), common mental disorder (CMD) (i.e. depression without psychotic features, anxiety disorders). Findings: the 4020 COVID-19 deaths included in the study took place in 365 hospitals across Italy. Out of the 4020 deceased patients, 84 (2•1%) had a previous SPD, 177 (4.4%) a CMD. The mean age at death was 78.0 (95%CI 77.6–78.3) years among patients without a PD, 71.8 (95%CI 69.3–72.0) among those with an SPD, 79.5 (95%CI 78.0–81.1) in individuals with a CMD. 2253 (61.2%) patients without a PD, 62 (73.8%) with an SPD, and 136 (78.2%) with a CMD were diagnosed with three or more non-psychiatric comorbidities.When we adjusted for clinically relevant variables, including hospital of death, we found that SPD patients died at a younger age than those without a PD (adjusted OR per 1 year increment 0.96; 95% CI 0.94–0.98). Women were significantly more represented among CMD patients compared to patients without previous psychiatric history (aOR 1.56; 95% CI 1.05–2.32). Hospital admission from long-term care facilities (LTCFs) was strongly associated with having an SPD (aOR 9.02; 95% CI 4.99–16.3) or a CMD (aOR 2.09; 95% CI 1.19–3.66). Comorbidity burden, fever, admission to intensive care and time from symptoms’ onset to nasopharyngeal swab did not result significantly associated with an SPD or with a CMD in comparison to those without any PD. Interpretation: even where equal treatment is in place, the vulnerability of patients with a PD may reduce their chance of recovering from COVID-19. The promotion of personalised therapeutic projects aimed at including people with PD in the community rather than in non-psychiatric LTCFs should be prioritised.http://www.sciencedirect.com/science/article/pii/S2589537021001346Psychiatric disordersSARS-CoV-2COVID-19DeathHospital |
| spellingShingle | Ilaria Lega Lorenza Nisticò Luigi Palmieri Emanuele Caroppo Cinzia Lo Noce Chiara Donfrancesco Nicola Vanacore Maria Luisa Scattoni Angelo Picardi Antonella Gigantesco Silvio Brusaferro Graziano Onder Psychiatric disorders among hospitalized patients deceased with COVID-19 in Italy EClinicalMedicine Psychiatric disorders SARS-CoV-2 COVID-19 Death Hospital |
| title | Psychiatric disorders among hospitalized patients deceased with COVID-19 in Italy |
| title_full | Psychiatric disorders among hospitalized patients deceased with COVID-19 in Italy |
| title_fullStr | Psychiatric disorders among hospitalized patients deceased with COVID-19 in Italy |
| title_full_unstemmed | Psychiatric disorders among hospitalized patients deceased with COVID-19 in Italy |
| title_short | Psychiatric disorders among hospitalized patients deceased with COVID-19 in Italy |
| title_sort | psychiatric disorders among hospitalized patients deceased with covid 19 in italy |
| topic | Psychiatric disorders SARS-CoV-2 COVID-19 Death Hospital |
| url | http://www.sciencedirect.com/science/article/pii/S2589537021001346 |
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