Arai Yusuke, Sasayama Daimei, Kuraishi Akira, Sahara Reiko, Murata Shiho, Tanaka Akira, Amemiya Kotaro, Usuda Nobuteru, Kuraishi Kazuaki, Washizuka Shinsuke
Department of Psychiatry, Shinshu University School of Medicine, Matsumoto-City 390-8621, Japan.
Department of Psychiatry, Kurita Hospital, Nagano-City 380-0921, Japan.
J Clin Med. 2023 Sep 13;12(18):5953. doi: 10.3390/jcm12185953.
Schizophrenia is a known risk factor for coronavirus disease (COVID-19) infection and severity, and certain psychotropic drugs have been linked to increased mortality in infected patients with schizophrenia. However, little evidence exists regarding this risk. We retrospectively examined the association between mood stabilizers and the risk of pneumonia in patients with schizophrenia. This study included 99 patients with schizophrenia or schizoaffective disorder who were infected with COVID-19 in 2022 and met the inclusion criteria. After conducting propensity score matching to align patient backgrounds and concomitant medications, we assessed the impact of mood stabilizers, specifically sodium valproate, on the risk of pneumonia development. Univariate analysis revealed that patients with schizophrenia and COVID-19 who developed pneumonia were more likely to be older (64.5 [14.2] vs. 57.4 [11.5] years, = 0.008) and using sodium valproate (44.4% vs. 16.7%, = 0.004). Even after propensity score matching, patients who developed pneumonia were still more likely to be receiving sodium valproate than not (58.8% vs. 20.0%, = 0.003). Sodium valproate use may be a risk factor for the development of pneumonia in patients with chronic schizophrenia who are infected with COVID-19 during long-term hospitalization.
精神分裂症是冠状病毒病（COVID-19）感染及其严重程度的已知风险因素，某些精神药物与精神分裂症感染患者的死亡率增加有关。然而，关于这种风险的证据很少。我们回顾性研究了心境稳定剂与精神分裂症患者肺炎风险之间的关联。本研究纳入了2022年感染COVID-19且符合纳入标准的99例精神分裂症或分裂情感性障碍患者。在进行倾向评分匹配以平衡患者背景和伴随用药情况后，我们评估了心境稳定剂，特别是丙戊酸钠，对肺炎发生风险的影响。单因素分析显示，发生肺炎的精神分裂症合并COVID-19患者年龄更大（64.5 [14.2]岁 vs. 57.4 [11.5]岁，P = 0.008）且使用丙戊酸钠的比例更高（44.4% vs. 16.7%，P = 0.004）。即使在倾向评分匹配后，发生肺炎的患者使用丙戊酸钠的可能性仍然高于未使用者（58.8% vs. 20.0%，P = 0.003）。在长期住院期间感染COVID-19的慢性精神分裂症患者中，使用丙戊酸钠可能是发生肺炎的一个风险因素。
