Maripuu Martin, Bendix Marie, Öhlund Louise, Widerström Micael, Werneke Ursula
Division of Psychiatry, Department of Clinical Sciences, Umeå University, Umeå, Sweden.
Department of Clinical Neuroscience, Center for Psychiatry Research & Stockholm Health Care Services, Stockholm County Council, Karolinska Institutet, Stockholm, Sweden.
Front Psychiatry. 2021 Jan 8;11:609579. doi: 10.3389/fpsyt.2020.609579. eCollection 2020.
Individuals with severe mental disorder (SMD) have a higher risk of somatic comorbidity and mortality than the rest of the population. We set up a population-based study to assess whether individuals with SMD had a higher risk of death associated with a COVID-19 infection (COVID-19 associated death) than individuals without SMD. Exploratory analysis with a cross-sectional design in the framework of a population-based register study covering the entire Swedish population. The Swedish Board for Health and Welfare (Socialstyrelsen) provided anonymized tabulated summary data for further analysis. We compared numbers of COVID-19 associated death in individuals with SMD (cases) and without SMD (controls). We calculated the odds ratio (OR) for the whole sample and by age group and four comorbidities, namely diabetes, cardiovascular disease, hypertension, chronic lung disease. The sample comprised of 7,923,859 individuals, 103,999 with SMD and 7,819,860 controls. There were 130 (0.1%) COVID-19 associated deaths in the SMD group and 4,945 (0.06%) in the control group, corresponding to an OR of 1.98 (CI 1.66-2.35; p < 0.001). The odds were 4-fold for the age groups between 60 and 79 years and 1.5-fold for cardiovascular diseases. Individuals with SMD without any of the risk factors under study had 3-fold odds of COVID-19 associated death. Our preliminary results identify individuals with SMD as a further group at increased risk of COVID-19 associated death. In regard to comorbidities, future studies should explore the potential confounding or mediation role in the relationship between SMD and COVID-19 associated deaths.
患有严重精神障碍（SMD）的个体比其他人群有更高的躯体合并症风险和死亡率。我们开展了一项基于人群的研究，以评估患有SMD的个体与未患SMD的个体相比，是否有更高的与2019冠状病毒病（COVID-19）感染相关的死亡风险（COVID-19相关死亡）。在一项覆盖瑞典全体人口的基于人群登记研究框架内，采用横断面设计进行探索性分析。瑞典卫生和福利委员会（Socialstyrelsen）提供了匿名的列表汇总数据以供进一步分析。我们比较了患有SMD的个体（病例）和未患SMD的个体（对照）中COVID-19相关死亡的数量。我们计算了整个样本以及按年龄组和四种合并症（即糖尿病、心血管疾病、高血压、慢性肺病）划分的比值比（OR）。样本包括7,923,859名个体，其中103,999名患有SMD，7,819,860名作为对照。SMD组有130例（0.1%）COVID-19相关死亡，对照组有4,945例（0.06%），对应OR为1.98（95%置信区间1.66 - 2.35；p < 0.001）。60至79岁年龄组的比值为4倍，心血管疾病患者的比值为1.5倍。没有任何所研究风险因素的SMD个体发生COVID-19相关死亡的几率为3倍。我们的初步结果表明，患有SMD的个体是另一组COVID-19相关死亡风险增加的人群。关于合并症，未来的研究应探讨其在SMD与COVID-19相关死亡之间关系中的潜在混杂或中介作用。
