Increased risk of COVID-19 infection and mortality in people with mental disorders: analysis from electronic health records in the United States.
Increased risk of COVID-19 infection and mortality in people with mental disorders: analysis from electronic health records in the United States.
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DOI：
10.1002/wps.20806
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发表时间：
2021-03
期刊：
影响因子：
--
通讯作者：
Volkow ND
中科院分区：
文献类型：
--
作者：
Wang Q;Xu R;Volkow ND
有人担心，患有既存精神障碍的人可能代表了感染COVID-19的风险增加的人群，并且感染的不良后果的可能性更高，但在这方面没有系统的研究证据。这项研究评估了最近（过去一年内）诊断出精神障碍（包括注意力缺陷多动障碍（ADHD）、双相情感障碍、抑郁症和精神分裂症）对COVID-19感染风险以及相关死亡率和住院率的影响。我们分析了截至2020年7月29日，来自美国50个州的360家医院和317，000家供应商的6100万成年患者的全国电子健康记录数据库。最近诊断出精神障碍的患者感染COVID-19的风险显着增加，对抑郁症（调整后的比值比，AOR=7.64，95%CI：7.45 - 7.83，p<0.001）和精神分裂症（AOR=7.34，95%CI：6.65 - 8.10，p<0.001）的影响最大。在最近诊断为精神障碍的患者中，非洲裔美国人感染COVID-19的几率高于白人，抑郁症的种族差异最大（AOR=3.78，95% CI：3.58 - 3.98，p<0.001）。患有精神障碍的女性感染COVID-19的几率高于男性，ADHD的性别差异最大（AOR=2.03，95%CI：1.73 - 2.39，p<0.001）。近期诊断为精神障碍和COVID-19感染的患者的死亡率为8.5%（与无精神障碍的COVID-19患者的4.7%相比，p<0.001），住院率为27.4%（与无精神障碍的COVID-19患者的18.6%相比，p<0.001）。这些发现确定了最近诊断出精神障碍的个人感染COVID-19的风险增加，这在非洲裔美国人和妇女中进一步加剧，并且感染的一些不良后果的频率更高。这一证据强调了识别和解决COVID-19感染的可改变脆弱性因素的必要性，并防止在这一人群中延迟医疗保健提供。
Concerns have been expressed that persons with a pre‐existing mental disorder may represent a population at increased risk for COVID‐19 infection and with a higher likelihood of adverse outcomes of the infection, but there is no systematic research evidence in this respect. This study assessed the impact of a recent (within past year) diagnosis of a mental disorder – including attention‐deficit/hyperactivity disorder (ADHD), bipolar disorder, depression and schizophrenia – on the risk for COVID‐19 infection and related mortality and hospitalization rates. We analyzed a nation‐wide database of electronic health records of 61 million adult patients from 360 hospitals and 317,000 providers, across 50 states in the US, up to July 29, 2020. Patients with a recent diagnosis of a mental disorder had a significantly increased risk for COVID‐19 infection, an effect strongest for depression (adjusted odds ratio, AOR=7.64, 95% CI: 7.45‐7.83, p<0.001) and schizophrenia (AOR=7.34, 95% CI: 6.65‐8.10, p<0.001). Among patients with a recent diagnosis of a mental disorder, African Americans had higher odds of COVID‐19 infection than Caucasians, with the strongest ethnic disparity for depression (AOR=3.78, 95% CI: 3.58‐3.98, p<0.001). Women with mental disorders had higher odds of COVID‐19 infection than males, with the strongest gender disparity for ADHD (AOR=2.03, 95% CI: 1.73‐2.39, p<0.001). Patients with both a recent diagnosis of a mental disorder and COVID‐19 infection had a death rate of 8.5% (vs. 4.7% among COVID‐19 patients with no mental disorder, p<0.001) and a hospitalization rate of 27.4% (vs. 18.6% among COVID‐19 patients with no mental disorder, p<0.001). These findings identify individuals with a recent diagnosis of a mental disorder as being at increased risk for COVID‐19 infection, which is further exacerbated among African Americans and women, and as having a higher frequency of some adverse outcomes of the infection. This evidence highlights the need to identify and address modifiable vulnerability factors for COVID‐19 infection and to prevent delays in health care provision in this population.
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DOI：
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发表时间：
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影响因子：
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