Mortality in association with antipsychotic medication use and clinical outcomes among geriatric psychiatry outpatients with COVID-19.
<h4>Objectives</h4>Older adults are particularly vulnerable to the negative consequences of antipsychotic exposure and are disproportionally affected by higher mortality from coronavirus disease 2019 (COVID-19). Our goal was to determine whether concurrent antipsychotic medication use wa...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2021-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0258916 |
| _version_ | 1819102353496735744 |
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| author | Bienvenida Austria Rehana Haque Sukriti Mittal Jamie Scott Aninditha Vengassery Daniel Maltz Wentian Li Blaine Greenwald Yun Freudenberg-Hua |
| author_facet | Bienvenida Austria Rehana Haque Sukriti Mittal Jamie Scott Aninditha Vengassery Daniel Maltz Wentian Li Blaine Greenwald Yun Freudenberg-Hua |
| author_sort | Bienvenida Austria |
| collection | DOAJ |
| description | <h4>Objectives</h4>Older adults are particularly vulnerable to the negative consequences of antipsychotic exposure and are disproportionally affected by higher mortality from coronavirus disease 2019 (COVID-19). Our goal was to determine whether concurrent antipsychotic medication use was associated with increased COVID-19 mortality in older patients with preexisting behavioral health problems. We also report on findings from post-COVID follow-ups.<h4>Design</h4>Retrospective observational study.<h4>Participants</h4>Outpatients at a geriatric psychiatric clinic in New York City.<h4>Measurements</h4>Demographic and clinical data including medication, diagnosis and Clinical Global Impression Severity (CGI-S) scales on outpatients who had COVID-19 between February 28th and October 1st 2020 were extracted from the electronic health records (EHR) from the hospital.<h4>Results</h4>A total of 56 patients were diagnosed with COVID-19 (mean age 76 years; median age 75 years) and 13 (23.2%) died. We found an increased mortality risk for patients who were prescribed at least one antipsychotic medication at the time of COVID-19 infection (Fisher's exact test P = 0.009, OR = 11.1, 95% confidence interval: 1.4-96.0). This result remains significant after adjusting for age, gender, housing context and dementia (Logistic regression P = 0.035, Beta = 2.4). Furthermore, we found that most patients who survived COVID-19 (88.4%) recovered to pre-COVID baseline in terms of psychiatric symptoms. Comparison of pre- and post-COVID assessments of CGI-S for 33 patients who recovered from COVID-19 were not significantly different.<h4>Conclusion</h4>We observed a higher COVID-19 mortality associated with concurrent antipsychotics use in older patients receiving behavioral health services. The majority of patients in our geriatric clinic who recovered from COVID-19 appeared to return to their pre-COVID psychiatric function. More precise estimates of the risk associated with antipsychotic treatment in older patients with COVID-19 and other underlying factors will come from larger datasets and meta-analyses. |
| first_indexed | 2024-12-22T01:33:13Z |
| format | Article |
| id | doaj.art-ab1a56a3306c48df9aa1a44df3b1d5e9 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-22T01:33:13Z |
| publishDate | 2021-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-ab1a56a3306c48df9aa1a44df3b1d5e92022-12-21T18:43:27ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-011610e025891610.1371/journal.pone.0258916Mortality in association with antipsychotic medication use and clinical outcomes among geriatric psychiatry outpatients with COVID-19.Bienvenida AustriaRehana HaqueSukriti MittalJamie ScottAninditha VengasseryDaniel MaltzWentian LiBlaine GreenwaldYun Freudenberg-Hua<h4>Objectives</h4>Older adults are particularly vulnerable to the negative consequences of antipsychotic exposure and are disproportionally affected by higher mortality from coronavirus disease 2019 (COVID-19). Our goal was to determine whether concurrent antipsychotic medication use was associated with increased COVID-19 mortality in older patients with preexisting behavioral health problems. We also report on findings from post-COVID follow-ups.<h4>Design</h4>Retrospective observational study.<h4>Participants</h4>Outpatients at a geriatric psychiatric clinic in New York City.<h4>Measurements</h4>Demographic and clinical data including medication, diagnosis and Clinical Global Impression Severity (CGI-S) scales on outpatients who had COVID-19 between February 28th and October 1st 2020 were extracted from the electronic health records (EHR) from the hospital.<h4>Results</h4>A total of 56 patients were diagnosed with COVID-19 (mean age 76 years; median age 75 years) and 13 (23.2%) died. We found an increased mortality risk for patients who were prescribed at least one antipsychotic medication at the time of COVID-19 infection (Fisher's exact test P = 0.009, OR = 11.1, 95% confidence interval: 1.4-96.0). This result remains significant after adjusting for age, gender, housing context and dementia (Logistic regression P = 0.035, Beta = 2.4). Furthermore, we found that most patients who survived COVID-19 (88.4%) recovered to pre-COVID baseline in terms of psychiatric symptoms. Comparison of pre- and post-COVID assessments of CGI-S for 33 patients who recovered from COVID-19 were not significantly different.<h4>Conclusion</h4>We observed a higher COVID-19 mortality associated with concurrent antipsychotics use in older patients receiving behavioral health services. The majority of patients in our geriatric clinic who recovered from COVID-19 appeared to return to their pre-COVID psychiatric function. More precise estimates of the risk associated with antipsychotic treatment in older patients with COVID-19 and other underlying factors will come from larger datasets and meta-analyses.https://doi.org/10.1371/journal.pone.0258916 |
| spellingShingle | Bienvenida Austria Rehana Haque Sukriti Mittal Jamie Scott Aninditha Vengassery Daniel Maltz Wentian Li Blaine Greenwald Yun Freudenberg-Hua Mortality in association with antipsychotic medication use and clinical outcomes among geriatric psychiatry outpatients with COVID-19. PLoS ONE |
| title | Mortality in association with antipsychotic medication use and clinical outcomes among geriatric psychiatry outpatients with COVID-19. |
| title_full | Mortality in association with antipsychotic medication use and clinical outcomes among geriatric psychiatry outpatients with COVID-19. |
| title_fullStr | Mortality in association with antipsychotic medication use and clinical outcomes among geriatric psychiatry outpatients with COVID-19. |
| title_full_unstemmed | Mortality in association with antipsychotic medication use and clinical outcomes among geriatric psychiatry outpatients with COVID-19. |
| title_short | Mortality in association with antipsychotic medication use and clinical outcomes among geriatric psychiatry outpatients with COVID-19. |
| title_sort | mortality in association with antipsychotic medication use and clinical outcomes among geriatric psychiatry outpatients with covid 19 |
| url | https://doi.org/10.1371/journal.pone.0258916 |
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