Weill Cornell Medicine / Psychiatry, USA.
New York Presbyterian Hospital, USA.
Psychiatry Res. 2021 Apr;298:113833. doi: 10.1016/j.psychres.2021.113833. Epub 2021 Feb 23.
Some psychiatric hospitals have instituted mandatory COVID-19 testing for all patients referred for admission. Others have permitted patients to decline testing. Little is known about the rate of COVID-19 infection in acute psychiatric inpatients. Characterizing the proportion of infected patients who have an asymptomatic presentation will help inform policy regarding universal mandatory versus symptom-based or opt-out testing protocols. We determined the COVID-19 infection rate and frequency of asymptomatic presentation in 683 consecutively admitted patients during the surge in the New York City region between April 3rd, 2020 and June 8th, 2020. Among these psychiatric inpatients, there was a 9.8 % overall rate of COVID-19 infection. Of the COVID-19 infected patients, approximately 76.1 % (51/67) either had no COVID-19 symptoms or could not offer reliable history of symptoms at the time of admission. Had they not been identified by testing and triaged to a COVID-19 positive unit, they could have infected others, leading to institutional outbreak. These findings provide justification for psychiatric facilities to maintain universal mandatory testing policies, at least until community infection rates fall and remain at very low levels.
一些精神病医院对所有转介住院的患者进行强制性 COVID-19 检测。其他医院则允许患者拒绝检测。目前对于急性精神病住院患者中 COVID-19 感染率知之甚少。描述无症状表现的感染患者比例将有助于为通用强制性与基于症状或选择退出检测方案的政策提供信息。我们在 2020 年 4 月 3 日至 6 月 8 日期间，在纽约市地区的疫情高峰期，对 683 名连续入院的患者进行了 COVID-19 感染率和无症状表现频率的测定。在这些精神病住院患者中，COVID-19 的总感染率为 9.8%。在 COVID-19 感染患者中，约 76.1%（51/67）要么没有 COVID-19 症状，要么在入院时无法提供可靠的症状史。如果他们没有通过检测被发现并被分诊到 COVID-19 阳性病房，他们可能会感染其他人，导致机构内爆发。这些发现为精神病院维持通用强制性检测政策提供了依据，至少在社区感染率下降并保持在非常低的水平之前是这样。
