Division of Health Information, Ministry of Health, Jerusalem, Israel.
Mental Health Division, Ministry of Health, Jerusalem, Israel.
Mol Psychiatry. 2022 Jul;27(7):3107-3114. doi: 10.1038/s41380-022-01562-2. Epub 2022 Apr 22.
Previous studies on psychiatric patients infected with COVID-19 have reported a more severe course of disease and higher rates of mortality compared with the general population. This cohort study linked Israeli national databases including all individuals ever hospitalized for a psychiatric disorder (cases), and COVID-19 testing, infection, hospitalization, mortality, and vaccinations, between March 1 2020 and March 31 2021. Cases were 125,273 individuals aged 18 and above ever hospitalized in a psychiatric facility (ICD-10 F10-F69 or F90-F99), compared to the total population, n = 6,143,802. Compared with the total population, cases were less likely to be tested for COVID-19, 51.2% (95% CI: 50.8-51.7) vs 62.3% (95% CI 62.2-62.4) and had lower rates of confirmed COVID infection, 5.9% (95% CI: 5.8-6.1) vs 8.9% (95% CI: 8.9-8.9). Among those infected, risks for COVID-19 hospitalization, COVID-19 attributed mortality and all-cause mortality were higher for cases than the total population, adjusted odds ratios were 2.10; (95% CI: 1.96-2.25), 1.76; (95% CI: 1.54-2.01) and 2.02; (95% CI: 1.80-2.28), respectively. These risks were even higher for cases with non-affective psychotic disorders and bipolar disorder. Age adjusted rates of vaccination were lower in cases, 60.4% (95% CI: 59.9-60.8) vs 74.9% (95% CI: 74.8-75.0) in the total population, and particularly low for cases with non-affective psychotic disorders, 56.9% (95% CI: 56.3-57.6). This study highlights the need to increase testing for COVID-19 in individuals ever hospitalized for a psychiatric disorder, closely monitor those found positive, and to reach out to encourage vaccination.
先前针对 COVID-19 感染精神科患者的研究报告显示，与普通人群相比，这些患者的疾病严重程度更高，死亡率也更高。这项队列研究将以色列全国数据库进行了关联，其中包含了所有曾因精神障碍住院的个体（病例）以及 COVID-19 的检测、感染、住院、死亡和接种情况，时间范围为 2020 年 3 月 1 日至 2021 年 3 月 31 日。病例组为 125273 名年龄在 18 岁及以上、曾在精神科医疗机构住院（ICD-10 F10-F69 或 F90-F99）的个体，与总人口（n=6143802）相比。与总人口相比，病例组接受 COVID-19 检测的可能性较低，为 51.2%（95%CI：50.8-51.7），而总人口为 62.3%（95%CI：62.2-62.4）；确诊 COVID 感染的比例也较低，为 5.9%（95%CI：5.8-6.1），而总人口为 8.9%（95%CI：8.9-8.9）。在感染 COVID-19 的人群中，病例组因 COVID-19 住院、COVID-19 归因死亡率和全因死亡率的风险高于总人口，调整后的优势比分别为 2.10（95%CI：1.96-2.25）、1.76（95%CI：1.54-2.01）和 2.02（95%CI：1.80-2.28）。对于非情感性精神病性障碍和双相情感障碍的病例，这些风险更高。病例组的疫苗接种率也较低，年龄调整后为 60.4%（95%CI：59.9-60.8），而总人口为 74.9%（95%CI：74.8-75.0），非情感性精神病性障碍的病例组尤其低，为 56.9%（95%CI：56.3-57.6）。这项研究强调了需要增加对曾因精神障碍住院的个体进行 COVID-19 检测，密切监测检测结果阳性的个体，并主动联系他们以鼓励接种疫苗。
