Prevalence, management, and outcomes of SARS-CoV-2 infections in older people and those with dementia in mental health wards in London, UK: a retrospective observational study.
Prevalence, management, and outcomes of SARS-CoV-2 infections in older people and those with dementia in mental health wards in London, UK: a retrospective observational study.
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DOI：
10.1016/s2215-0366(20)30434-x
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发表时间：
2020-12
期刊：
影响因子：
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通讯作者：
Marston L
中科院分区：
文献类型：
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作者：
Livingston G;Rostamipour H;Gallagher P;Kalafatis C;Shastri A;Huzzey L;Liu K;Sommerlad A;Marston L
生活在群体中的人或患有痴呆症的人更容易感染严重急性呼吸综合征冠状病毒2 （SARS-CoV-2）。老年人和患有多种疾病的人如果受到感染，死亡率高于一般人群。然而，目前还没有对精神科老年住院患者的covid -19相关结果进行系统研究，这些患者来自这些高危人群。我们的目的是描述2020年3月1日至4月30日期间，英国伦敦五个国家卫生服务信托基金中老年住院精神病患者和年轻发病的痴呆症患者中COVID-19的流行率、人口统计学、症状（和无症状病例）、管理和生存结果。在这项回顾性观察性研究中，我们收集了2020年3月1日至4月30日期间已在伦敦五家精神卫生信托基金住院或住院的65岁及以上或患有痴呆症的住院患者的人口统计数据、精神健康诊断、COVID-19临床诊断、症状、管理和COVID-19相关结果数据，以及有关COVID-19相关资源（即测试和个人防护装备）的信息。如果患者的SARS-CoV-2 PCR检测呈阳性，或有相关症状表明患有COVID-19，则由其治疗医生确定为患者患有COVID-19。我们计算了COVID-19的期间患病率，并分析了患者的特征、治疗和结局。在344名住院患者中，131名（38%）在研究期间被诊断为COVID-19（期间患病率38% [95% CI 33-43]）。COVID-19患者的平均年龄为75.3岁（SD 8.2）；其中女性68人（52%），少数民族47人（36%）。131例患者中16例（12%）无症状，121例（92%）有一种或多种疾病相关合并症。强制拘留108例（82%）。74例（56%）患者患有痴呆，其中13例（18%）为早发型痴呆。平均而言，站点在首次临床COVID-19出现后4.5天收到COVID-19检测试剂盒。19例（15%）诊断为COVID-19的患者在研究期间死亡，并确定其死亡与COVID-19相关。入院时未感染SARS-CoV-2的精神科住院患者感染SARS-CoV-2的风险高于社区患者，COVID-19死亡比例高于社区患者。在精神病院执行尊重精神健康的平等长期政策和规划未来的COVID-19浪潮迫在眉睫。没有。
People living in group situations or with dementia are more vulnerable to infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Older people and those with multimorbidity have higher mortality if they become infected than the general population. However, no systematic study exists of COVID-19-related outcomes in older inpatients in psychiatric units, who comprise people from these high-risk groups. We aimed to describe the period prevalence, demographics, symptoms (and asymptomatic cases), management, and survival outcomes of COVID-19 in the older inpatient psychiatric population and people with young-onset dementia in five National Health Service Trusts in London, UK, from March 1 to April 30, 2020. In this retrospective observational study, we collected demographic data, mental health diagnoses, clinical diagnosis of COVID-19, symptoms, management, and COVID-19-related outcome data of inpatients aged 65 years or older or with dementia who were already inpatients or admitted as inpatients to five London mental health Trusts between March 1 and April 30, 2020, and information about available COVID-19-related resources (ie, testing and personal protective equipment). Patients were determined to have COVID-19 if they had a positive SARS-CoV-2 PCR test, or had relevant symptoms indicative of COVID-19, as determined by their treating physician. We calculated period prevalence of COVID-19 and analysed patients’ characteristics, treatments, and outcomes. Of 344 inpatients, 131 (38%) were diagnosed with COVID-19 during the study period (period prevalence 38% [95% CI 33–43]). The mean age of patients who had COVID-19 was 75·3 years (SD 8·2); 68 (52%) were women and 47 (36%) from ethnic minority groups. 16 (12%) of 131 patients were asymptomatic and 121 (92%) had one or more disease-related comorbidity. 108 (82%) patients were compulsorily detained. 74 (56%) patients had dementia, of whom 13 (18%) had young-onset dementia. On average, sites received COVID-19 testing kits 4·5 days after the first clinical COVID-19 presentation. 19 (15%) patients diagnosed with COVID-19 died during the study period, and their deaths were determined to be COVID-19 related. Patients in psychiatric inpatient settings who were admitted without known SARS-CoV-2 infection had a high risk of infection with SARS-CoV-2 compared with those in the community and had a higher proportion of deaths from COVID-19 than in the community. Implementation of the long-standing policy of parity of esteem for mental health and planning for future COVID-19 waves in psychiatric hospitals is urgent. None.