Association of mental disorders with SARS-CoV-2 infection and severe health outcomes: nationwide cohort study
Association of mental disorders with SARS-CoV-2 infection and severe health outcomes: nationwide cohort study
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DOI：
10.1192/bjp.2020.251
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发表时间：
2021-06-01
影响因子：
10.5
通讯作者：
Shin, Ju-Young
中科院分区：
文献类型：
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作者：
Jeon, Ha-Lim;Kwon, Jun Soo;Shin, Ju-Young
关于精神障碍与严重急性呼吸综合征冠状病毒2 （SARS-CoV-2）感染风险和2019年冠状病毒病（COVID-19）严重程度之间关联的流行病学数据有限。目的评价精神障碍与SARS-CoV-2感染风险和COVID-19后严重结局之间的关系。方法采用基于国民健康保险数据的韩国COVID-19患者数据库进行队列研究。每个患有精神或行为障碍的人（在第一次SARS-CoV-2检测前6个月内被诊断出来）按年龄、性别和查尔森共病指数与多达4名没有精神障碍的人进行匹配。采用条件logistic回归分析计算感染后sars - cov -2阳性风险和死亡或严重事件（入住重症监护病房、使用机械通气和急性呼吸窘迫综合征）的风险。结果在230565例SARS-CoV-2检测人群中，33653例（14.6%）存在精神障碍；其中928/33 653例（2.76%）阳性，56/928例（6.03%）死亡。在使用匹配队列的多变量分析中，精神障碍与sars - cov -2阳性风险之间没有关联（优势比OR = 0.95; 95% CI 0.87-1.04）；然而，较高的风险与精神分裂症相关疾病相关（OR = 1.50; 95% CI 1.14-1.99）。在确诊的COVID-19患者中，精神障碍患者的死亡风险显著高于无精神障碍患者（OR = 1.99, 95% CI 1.15-3.43）。结论精神障碍可能是新冠肺炎患者死亡的重要因素。尽管精神障碍患者的感染风险总体上并不高，但精神分裂症相关疾病患者更容易受到感染。
BackgroundEpidemiological data on the association between mental disorders and the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and coronavirus disease 2019 (COVID-19) severity are limited.AimsTo evaluate the association between mental disorders and the risk of SARS-CoV-2 infection and severe outcomes following COVID-19.MethodWe performed a cohort study using the Korean COVID-19 patient database based on national health insurance data. Each person with a mental or behavioural disorder (diagnosed during the 6 months prior to their first SARS-CoV-2 test) was matched by age, gender and Charlson Comorbidity Index with up to four people without mental disorders. SARS-CoV-2-positivity risk and the risk of death or severe events (intensive care unit admission, use of mechanical ventilation and acute respiratory distress syndrome) post-infection were calculated using conditional logistic regression analysis.ResultsAmong 230 565 people tested for SARS-CoV-2, 33 653 (14.6%) had mental disorders; 928/33 653 (2.76%) tested SARS-CoV-2 positive and 56/928 (6.03%) died. In multivariable analysis using the matched cohort, there was no association between mental disorders and SARS-CoV-2-positivity risk (odds ratio OR = 0.95; 95% CI 0.87-1.04); however, a higher risk was associated with schizophrenia-related disorders (OR = 1.50; 95% CI 1.14-1.99). Among confirmed COVID-19 patients, the mortality risk was significantly higher in patients with than in those without mental disorders (OR = 1.99, 95% CI 1.15-3.43).ConclusionsMental disorders are likely contributing factors to mortality following COVID-19. Although the infection risk was not higher for people with mental disorders overall, those with schizophrenia-related disorders were more vulnerable to infection.