Mental disorders, psychopharmacological treatments, and mortality in 2150 COVID-19 Spanish inpatients
Mental disorders, psychopharmacological treatments, and mortality in 2150 COVID-19 Spanish inpatients
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DOI：
10.1111/acps.13304
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发表时间：
2021-04-13
影响因子：
6.7
通讯作者：
Cuevas-Esteban, Jorge
中科院分区：
文献类型：
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作者：
Diez-Quevedo, Crisanto;Iglesias-Gonzalez, Maria;Cuevas-Esteban, Jorge
目的 确定 COVID-19 入院前和入院期间的精神障碍和精神药物治疗与死亡率有何关系。方法 研究纳入的受试者均为 2020 年 3 月 1 日至 11 月 17 日期间入住巴达洛纳（西班牙）三级大学医院、经临床和 PCR 确诊的 COVID-19 成年患者。数据从计算机化临床记录中匿名提取。结果 纳入 2,150 名受试者，占 57%男性，平均年龄61岁。 957 人（45%）登记有精神障碍史。在入院期间，12% 的无既往病史的患者被重新诊断为情绪或焦虑、压力或适应障碍。 10% 的病例被诊断为谵妄。 1011 名患者 (47%) 在入院期间接受了精神药物处方（36% 为苯二氮卓类药物、22% 为抗抑郁药、21% 为抗精神病药）。死亡率为17%。入院期间的谵妄和情绪障碍病史与较高的死亡风险独立相关（风险比分别为 1.39 和 1.52），而前一年的抗焦虑药/安眠药和抗抑郁药治疗与较低的死亡风险独立相关（风险比分别为 0.47 和 0.43）。结论 精神症状在因 COVID-19 感染住院的患者中非常常见。检测、诊断和治疗它们是确定疾病预后和功能恢复的关键。
Objective To determine how mental disorders and psychopharmacological treatments before and during COVID-19 hospital admissions are related to mortality.Methods Subjects included in the study were all adult patients with a diagnosis of COVID-19, confirmed clinically and by PCR, who were admitted to a tertiary university hospital in Badalona (Spain) between March 1 and November 17, 2020. Data were extracted anonymously from computerized clinical records.Results 2,150 subjects were included, 57% males, mean age 61 years. History of mental disorders was registered in 957 (45%). Throughout admission, de novo diagnosis of mood or anxiety, stress, or adjustment disorder was made in 12% of patients without previous history. Delirium was diagnosed in 10% of cases. 1011 patients (47%) received a psychotropic prescription during admission (36% benzodiazepines, 22% antidepressants, and 21% antipsychotics). Mortality rate was 17%. Delirium during admission and history of mood disorder were independently associated with higher mortality risk (hazard ratios, 1.39 and 1.52 respectively), while previous year's treatments with anxiolytics/hypnotics and antidepressants were independently associated with lower mortality risk (hazard ratios, 0.47 and 0.43, respectively).Conclusion Mental symptoms are very common in patients hospitalized for COVID-19 infection. Detecting, diagnosing, and treating them is key to determining the prognosis of the disease and functional recovery.