Nishihara Tomoe, Shibata Mao, Ohashi Ayako, Hiyama Kazutoshi, Yamashita Takafumi, Kuroiwa Mika, Sudo Nobuyuki
Department of Psychosomatic Medicine, National Hospital Organization Fukuoka Higashi Medical Center, Fukuoka, Japan.
Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Biopsychosoc Med. 2023 Nov 15;17(1):40. doi: 10.1186/s13030-023-00296-z.
Previous studies have shown that patients with Coronavirus Disease 2019 (COVID-19) are likely to be affected by delirium and other psychiatric complications. We aimed to evaluate the relation between COVID-19 vaccination status and referral of patients hospitalized with COVID-19 for consultation-liaison psychiatry services.
From the medical records used for this retrospective, single hospital-based study, 576 patients were identified who were over 18 years-of-age and hospitalized with a diagnosis of COVID-19 between March 2020 and March 2022. The data of 531 for whom the vaccine history was obtained from the medical records were available for analysis: 455 without and 76 with referral to consultation-liaison psychiatry. A history of COVID-19 vaccination at least two times was used in the analysis of the odds for referral to liaison psychiatric consultation: 95% confidence interval (CI) in multivariable logistic regression. The adjustment factors included sex, age, body mass index (BMI), severity of COVID-19, C-reactive protein level, medical history, and therapeutic factors such as the use of remdesivir, steroids, or mechanical ventilation.
The prevalence of psychiatric consultation was 14.3%. Patients without vaccination had a 7-times greater OR (95%CI:2.08-23.58) than vaccinated patients for a referral for consultation-liaison psychiatry services after adjusting for confounding factors.
Non-vaccination was associated with a greater likelihood of referral for consultation-liaison psychiatry service among these hospitalized Japanese patients with COVID-19, even after adjusting for clinical and therapeutic factors. It is possible that vaccination greatly lessens the need for the referral of COVID-19 patients for consultation-liaison psychiatry services.
先前的研究表明，2019冠状病毒病（COVID-19）患者可能会受到谵妄和其他精神并发症的影响。我们旨在评估COVID-19疫苗接种状况与因COVID-19住院并被转诊至会诊联络精神病学服务的患者之间的关系。
在这项基于单家医院的回顾性研究中，从病历中识别出576名年龄超过18岁且在2020年3月至2022年3月期间因COVID-19诊断而住院的患者。从病历中获取疫苗接种史的531名患者的数据可供分析：455名未转诊至会诊联络精神病学，76名转诊至会诊联络精神病学。在分析转诊至联络精神病学咨询的几率时，使用了至少接种两次COVID-19疫苗的病史：多变量逻辑回归中的95%置信区间（CI）。调整因素包括性别、年龄、体重指数（BMI）、COVID-19的严重程度（C反应蛋白水平）、病史以及治疗因素，如使用瑞德西韦、类固醇或机械通气。
精神科会诊的患病率为14.3%。在调整混杂因素后，未接种疫苗的患者被转诊至会诊联络精神病学服务的几率比接种疫苗患者高7倍（95%CI：2.08 - 23.58）。
在这些住院的日本COVID-19患者中，即使在调整临床和治疗因素后仍发现，未接种疫苗与转诊至会诊联络精神病学服务的可能性更大有关。疫苗接种很可能大大减少了COVID-19患者转诊至会诊联络精神病学服务的需求。
