Psychiatry Service, Hospital Universitari Germans Trias i Pujol, IGTP Campus Can Ruti, Badalona, Spain.
Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain.
Acta Psychiatr Scand. 2021 Jun;143(6):526-534. doi: 10.1111/acps.13304. Epub 2021 Apr 13.
To determine how mental disorders and psychopharmacological treatments before and during COVID-19 hospital admissions are related to mortality.
Subjects included in the study were all adult patients with a diagnosis of COVID-19, confirmed clinically and by PCR, who were admitted to a tertiary university hospital in Badalona (Spain) between March 1 and November 17, 2020. Data were extracted anonymously from computerized clinical records.
2,150 subjects were included, 57% males, mean age 61 years. History of mental disorders was registered in 957 (45%). Throughout admission, de novo diagnosis of mood or anxiety, stress, or adjustment disorder was made in 12% of patients without previous history. Delirium was diagnosed in 10% of cases. 1011 patients (47%) received a psychotropic prescription during admission (36% benzodiazepines, 22% antidepressants, and 21% antipsychotics). Mortality rate was 17%. Delirium during admission and history of mood disorder were independently associated with higher mortality risk (hazard ratios, 1.39 and 1.52 respectively), while previous year's treatments with anxiolytics/hypnotics and antidepressants were independently associated with lower mortality risk (hazard ratios, 0.47 and 0.43, respectively).
Mental symptoms are very common in patients hospitalized for COVID-19 infection. Detecting, diagnosing, and treating them is key to determining the prognosis of the disease and functional recovery.
确定 COVID-19 住院前和住院期间的精神障碍和精神药理学治疗与死亡率的关系。
研究对象包括所有 2020 年 3 月 1 日至 11 月 17 日期间在巴达洛纳(西班牙)的一所三级大学医院临床确诊和 PCR 确诊的 COVID-19 成年住院患者。数据从计算机化的临床记录中匿名提取。
共纳入 2150 例患者,其中 57%为男性,平均年龄 61 岁。957 例(45%)有精神障碍史。在住院期间,12%的无既往病史患者新发心境或焦虑、应激或适应障碍,10%的患者诊断为谵妄。1011 例(47%)患者在住院期间接受了精神药物处方(36%苯二氮䓬类,22%抗抑郁药,21%抗精神病药)。死亡率为 17%。住院期间的谵妄和心境障碍史与更高的死亡率风险独立相关(风险比分别为 1.39 和 1.52),而前一年使用抗焦虑药/催眠药和抗抑郁药与更低的死亡率风险独立相关(风险比分别为 0.47 和 0.43)。
精神症状在因 COVID-19 感染住院的患者中非常常见。发现、诊断和治疗这些症状是确定疾病预后和功能恢复的关键。