Risk of death in individuals hospitalized for COVID-19 with and without psychiatric disorders: an observational multicenter study in France

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Hoertel, Nicolas | Sánchez-Rico, Marina | Muela, Pedro de La | Abellán, Miriam | Blanco, Carlos | Leboyer, Marion | Cougoule, Céline | Gulbins, Erich | Kornhuber, Johannes | Carpinteiro, Alexander | Becker, Katrin Anne | Vernet, Raphaël | Beeker, Nathanaël | Neuraz, Antoine | Alvarado, Jesús, M | Herrera-Morueco, Juan José | Airagnes, Guillaume | Lemogne, Cédric | Limosin, Frédéric

Edité par CCSD ; Elsevier -

International audience. Background: Prior research suggests that psychiatric disorders could be linked to increased mortality among patients with COVID-19. However, whether all or specific psychiatric disorders are intrinsic risk factors of death in COVID-19, or whether these associations reflect the greater prevalence of medical risk factors in people with psychiatric disorders, has yet to be evaluated.Methods: We performed an observational multicenter retrospective cohort study to examine the association between psychiatric disorders and mortality among patients hospitalized for laboratory-confirmed COVID-19 at 36 Greater Paris University hospitals.Results: Of 15,168 adult patients, 857 (5.7%) had an ICD-10 diagnosis of psychiatric disorder. Over a mean follow-up of 14.6 days (SD=17.9), death occurred in 326/857 (38.0%) patients with a diagnosis of psychiatric disorder versus 1,276/14,311 (8.9%) in patients without such a diagnosis (OR=6.27; 95%CI=5.40-7.28; p<0.01). When adjusting for age, sex, hospital, current smoking status, and medications according to compassionate use or as part of a clinical trial, this association remained significant (AOR=3.27; 95%CI=2.78-3.85; p<0.01). However, additional adjustments for obesity and number of medical conditions resulted in a non-significant association (AOR=1.02; 95%CI=0.84-1.23; p=0.86). Exploratory analyses following the same adjustments suggest that a diagnosis of mood disorders was significantly associated with reduced mortality, which might be explained by the use of antidepressants.Conclusions: These findings suggest that the increased risk of COVID-19-related mortality in individuals with psychiatric disorders hospitalized for COVID-19 might be explained by the greater number of medical conditions and the higher prevalence of obesity in this population, but not by the underlying psychiatric disease.

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