Risks of mental health outcomes in people with covid-19: cohort study.
Risks of mental health outcomes in people with covid-19: cohort study.
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DOI：
10.1136/bmj-2021-068993
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发表时间：
2022-02-16
期刊：
影响因子：
--
通讯作者：
Al-Aly Z
中科院分区：
文献类型：
--
作者：
Xie Y;Xu E;Al-Aly Z
估计新冠肺炎急性期幸存者发生精神健康障碍的风险。队列研究。美国退伍军人事务部。队列包括153848名在SARS-CoV-2感染后前30天存活的人，以及两个对照组：一个当代组（n= 5637840）没有SARS-CoV-2的证据，一个历史对照组（n= 5859251）在COVID-19大流行之前。预先设定的精神健康事件的风险，计算为一年内每1000人的风险比和绝对风险差，以及相应的95%置信区间。预定义的协变量和算法选择的高维协变量用于通过反向加权来平衡Covid-19和对照组。COVID-19组显示出焦虑症事件的风险增加（风险比1.35（95%置信区间1.30至1.39）;风险差11.06（95%置信区间9.64 - 12.53）/1000人，1年），抑郁症（1.39（1.34至1.43）; 15.12）（13.38至16.91）每1000人一年），压力和适应障碍（1.38（1.34至1.43）; 13.29）（每1000人一年11.71至14.92））和使用抗抑郁药（1.55（1.50至1.60）; 21.59（19.63至23.60）每1000人，一年）和苯二氮卓类（1.65（1.58至1.72）; 10.46（9.37至11.61）每1000人，一年）。阿片类药物处方事件的风险也增加了（1.76（1.71至1.81）; 35.90）（一年时每1 000人33.61至38.25）），类阿片使用障碍（1.34（1.21至1.48）; 0.96（0.59至1.37）每1000人在一年），和其他（非阿片类）物质使用障碍（1.20（1.15至1.26）; 4.34（3.22至5.51）每1000人在一年）。2019冠状病毒病组还显示出神经认知能力下降（1. 80（1. 72至1. 89）; 10. 75（9. 65至11. 91）每1000人一年）和睡眠障碍（1. 41（1. 38至1. 45）; 23. 80（21. 65至26. 00）每1000人一年）的风险增加。任何精神健康诊断或处方事件的风险增加（1.60（1.55至1.66）; 64.38（58.90至70.01）每1000人在一年）。即使在未入院的人群中，检查结果的风险也会增加，在新冠肺炎急性期入院的人群中，风险最高。结果与历史对照组一致。与未因季节性流感入院的COVID-19患者、因COVID-19入院的COVID-19患者与因季节性流感入院的COVID-19患者、因COVID-19入院的COVID-19患者与因任何其他原因入院的COVID-19患者相比，COVID-19患者组发生精神健康障碍的风险始终较高。研究结果表明，在新冠肺炎急性期幸存下来的人，患上一系列偶发性心理健康疾病的风险增加。应对新冠肺炎幸存者的心理健康障碍应该是一个优先事项。
To estimate the risks of incident mental health disorders in survivors of the acute phase of covid-19. Cohort study. US Department of Veterans Affairs. Cohort comprising 153 848 people who survived the first 30 days of SARS-CoV-2 infection, and two control groups: a contemporary group (n=5 637 840) with no evidence of SARS-CoV-2, and a historical control group (n=5 859 251) that predated the covid-19 pandemic. Risks of prespecified incident mental health outcomes, calculated as hazard ratio and absolute risk difference per 1000 people at one year, with corresponding 95% confidence intervals. Predefined covariates and algorithmically selected high dimensional covariates were used to balance the covid-19 and control groups through inverse weighting. The covid-19 group showed an increased risk of incident anxiety disorders (hazard ratio 1.35 (95% confidence interval 1.30 to 1.39); risk difference 11.06 (95% confidence interval 9.64 to 12.53) per 1000 people at one year), depressive disorders (1.39 (1.34 to 1.43); 15.12 (13.38 to 16.91) per 1000 people at one year), stress and adjustment disorders (1.38 (1.34 to 1.43); 13.29 (11.71 to 14.92) per 1000 people at one year), and use of antidepressants (1.55 (1.50 to 1.60); 21.59 (19.63 to 23.60) per 1000 people at one year) and benzodiazepines (1.65 (1.58 to 1.72); 10.46 (9.37 to 11.61) per 1000 people at one year). The risk of incident opioid prescriptions also increased (1.76 (1.71 to 1.81); 35.90 (33.61 to 38.25) per 1000 people at one year), opioid use disorders (1.34 (1.21 to 1.48); 0.96 (0.59 to 1.37) per 1000 people at one year), and other (non-opioid) substance use disorders (1.20 (1.15 to 1.26); 4.34 (3.22 to 5.51) per 1000 people at one year). The covid-19 group also showed an increased risk of incident neurocognitive decline (1.80 (1.72 to 1.89); 10.75 (9.65 to 11.91) per 1000 people at one year) and sleep disorders (1.41 (1.38 to 1.45); 23.80 (21.65 to 26.00) per 1000 people at one year). The risk of any incident mental health diagnosis or prescription was increased (1.60 (1.55 to 1.66); 64.38 (58.90 to 70.01) per 1000 people at one year). The risks of examined outcomes were increased even among people who were not admitted to hospital and were highest among those who were admitted to hospital during the acute phase of covid-19. Results were consistent with those in the historical control group. The risk of incident mental health disorders was consistently higher in the covid-19 group in comparisons of people with covid-19 not admitted to hospital versus those not admitted to hospital for seasonal influenza, admitted to hospital with covid-19 versus admitted to hospital with seasonal influenza, and admitted to hospital with covid-19 versus admitted to hospital for any other cause. The findings suggest that people who survive the acute phase of covid-19 are at increased risk of an array of incident mental health disorders. Tackling mental health disorders among survivors of covid-19 should be a priority.
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DOI：
10.1016/s0140-6736(21)02143-7
发表时间：
2021-11-06
期刊：
Lancet (London, England)
影响因子：
--
作者：
COVID-19 Mental Disorders Collaborators
通讯作者：
COVID-19 Mental Disorders Collaborators
DOI：
10.1097/ede.0b013e3181d61eeb
发表时间：
2010-05
期刊：
Epidemiology (Cambridge, Mass.)
影响因子：
--
作者：
Lipsitch M;Tchetgen Tchetgen E;Cohen T
通讯作者：
Cohen T
DOI：
10.1002/wps.20806
发表时间：
2021-03
期刊：
World psychiatry : official journal of the World Psychiatric Association (WPA)
影响因子：
--
作者：
Wang Q;Xu R;Volkow ND
通讯作者：
Volkow ND
影响因子：
64.8
作者：
Al-Aly, Ziyad;Xie, Yan;Bowe, Benjamin
通讯作者：
Bowe, Benjamin
影响因子：
15.8
作者：
Taquet M;Dercon Q;Luciano S;Geddes JR;Husain M;Harrison PJ
通讯作者：
Harrison PJ