Mortality in association with antipsychotic medication use and clinical outcomes among geriatric psychiatry outpatients with COVID-19.
Mortality in association with antipsychotic medication use and clinical outcomes among geriatric psychiatry outpatients with COVID-19.
复制标题
DOI：
10.1371/journal.pone.0258916
复制
发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Freudenberg-Hua Y
中科院分区：
文献类型：
--
作者：
Austria B;Haque R;Mittal S;Scott J;Vengassery A;Maltz D;Li W;Greenwald B;Freudenberg-Hua Y
老年人特别容易受到抗精神病药物暴露的负面影响，并且受到 2019 年冠状病毒病 (COVID-19) 较高死亡率的影响。我们的目标是确定同时使用抗精神病药物是否与先前存在行为健康问题的老年患者的 COVID-19 死亡率增加有关。我们还报告了新冠疫情后的后续调查结果。回顾性观察研究。纽约市一家老年精神病诊所的门诊病人。从医院的电子健康记录 (EHR) 中提取了 2020 年 2 月 28 日至 10 月 1 日期间患有 COVID-19 的门诊患者的人口统计和临床数据，包括用药、诊断和临床总体印象严重程度 (CGI-S) 量表。共有 56 名患者被诊断出患有 COVID-19（平均年龄 76 岁；中位年龄 75 岁），其中 13 人（23.2%）死亡。我们发现在感染 COVID-19 时至少服用一种抗精神病药物的患者死亡风险增加（Fisher 精确检验 P = 0.009，OR = 11.1，95% 置信区间：1.4–96.0）。在调整年龄、性别、住房环境和痴呆症后，这一结果仍然显着（Logistic 回归 P = 0.035，Beta = 2.4）。此外，我们发现大多数从 COVID-19 中幸存的患者 (88.4%) 的精神症状都恢复到了 COVID 前的基线水平。对 33 名从 COVID-19 中康复的患者的 CGI-S 评估前后进行比较，没有显着差异。我们观察到，在接受行为健康服务的老年患者中，同时使用抗精神病药物与 COVID-19 死亡率较高相关。在我们的老年诊所，大多数从 COVID-19 中康复的患者似乎都恢复到了新冠肺炎之前的精神功能。对老年 COVID-19 患者抗精神病治疗相关风险和其他潜在因素的更准确估计将来自更大的数据集和荟萃分析。
Older adults are particularly vulnerable to the negative consequences of antipsychotic exposure and are disproportionally affected by higher mortality from coronavirus disease 2019 (COVID-19). Our goal was to determine whether concurrent antipsychotic medication use was associated with increased COVID-19 mortality in older patients with preexisting behavioral health problems. We also report on findings from post-COVID follow-ups. Retrospective observational study. Outpatients at a geriatric psychiatric clinic in New York City. Demographic and clinical data including medication, diagnosis and Clinical Global Impression Severity (CGI-S) scales on outpatients who had COVID-19 between February 28th and October 1st 2020 were extracted from the electronic health records (EHR) from the hospital. A total of 56 patients were diagnosed with COVID-19 (mean age 76 years; median age 75 years) and 13 (23.2%) died. We found an increased mortality risk for patients who were prescribed at least one antipsychotic medication at the time of COVID-19 infection (Fisher’s exact test P = 0.009, OR = 11.1, 95% confidence interval: 1.4–96.0). This result remains significant after adjusting for age, gender, housing context and dementia (Logistic regression P = 0.035, Beta = 2.4). Furthermore, we found that most patients who survived COVID-19 (88.4%) recovered to pre-COVID baseline in terms of psychiatric symptoms. Comparison of pre- and post-COVID assessments of CGI-S for 33 patients who recovered from COVID-19 were not significantly different. We observed a higher COVID-19 mortality associated with concurrent antipsychotics use in older patients receiving behavioral health services. The majority of patients in our geriatric clinic who recovered from COVID-19 appeared to return to their pre-COVID psychiatric function. More precise estimates of the risk associated with antipsychotic treatment in older patients with COVID-19 and other underlying factors will come from larger datasets and meta-analyses.
登录
查看更多内容
影响因子：
--
作者：
Hossain MM;Tasnim S;Sultana A;Faizah F;Mazumder H;Zou L;McKyer ELJ;Ahmed HU;Ma P
通讯作者：
Ma P
DOI：
10.1136/bmj.m4509
发表时间：
2020-11-27
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Pastor-Barriuso R;Pérez-Gómez B;Hernán MA;Pérez-Olmeda M;Yotti R;Oteo-Iglesias J;Sanmartín JL;León-Gómez I;Fernández-García A;Fernández-Navarro P;Cruz I;Martín M;Delgado-Sanz C;Fernández de Larrea N;León Paniagua J;Muñoz-Montalvo JF;Blanco F;Larrauri A;Pollán M;ENE-COVID Study Group
通讯作者：
ENE-COVID Study Group
DOI：
10.1126/science.abe9403
发表时间：
2020-12-04
期刊：
Science (New York, N.Y.)
影响因子：
--
作者：
Gordon DE;Hiatt J;Bouhaddou M;Rezelj VV;Ulferts S;Braberg H;Jureka AS;Obernier K;Guo JZ;Batra J;Kaake RM;Weckstein AR;Owens TW;Gupta M;Pourmal S;Titus EW;Cakir M;Soucheray M;McGregor M;Cakir Z;Jang G;O'Meara MJ;Tummino TA;Zhang Z;Foussard H;Rojc A;Zhou Y;Kuchenov D;Hüttenhain R;Xu J;Eckhardt M;Swaney DL;Fabius JM;Ummadi M;Tutuncuoglu B;Rathore U;Modak M;Haas P;Haas KM;Naing ZZC;Pulido EH;Shi Y;Barrio-Hernandez I;Memon D;Petsalaki E;Dunham A;Marrero MC;Burke D;Koh C;Vallet T;Silvas JA;Azumaya CM;Billesbølle C;Brilot AF;Campbell MG;Diallo A;Dickinson MS;Diwanji D;Herrera N;Hoppe N;Kratochvil HT;Liu Y;Merz GE;Moritz M;Nguyen HC;Nowotny C;Puchades C;Rizo AN;Schulze-Gahmen U;Smith AM;Sun M;Young ID;Zhao J;Asarnow D;Biel J;Bowen A;Braxton JR;Chen J;Chio CM;Chio US;Deshpande I;Doan L;Faust B;Flores S;Jin M;Kim K;Lam VL;Li F;Li J;Li YL;Li Y;Liu X;Lo M;Lopez KE;Melo AA;Moss FR 3rd;Nguyen P;Paulino J;Pawar KI;Peters JK;Pospiech TH Jr;Safari M;Sangwan S;Schaefer K;Thomas PV;Thwin AC;Trenker R;Tse E;Tsui TKM;Wang F;Whitis N;Yu Z;Zhang K;Zhang Y;Zhou F;Saltzberg D;QCRG Structural Biology Consortium;Hodder AJ;Shun-Shion AS;Williams DM;White KM;Rosales R;Kehrer T;Miorin L;Moreno E;Patel AH;Rihn S;Khalid MM;Vallejo-Gracia A;Fozouni P;Simoneau CR;Roth TL;Wu D;Karim MA;Ghoussaini M;Dunham I;Berardi F;Weigang S;Chazal M;Park J;Logue J;McGrath M;Weston S;Haupt R;Hastie CJ;Elliott M;Brown F;Burness KA;Reid E;Dorward M;Johnson C;Wilkinson SG;Geyer A;Giesel DM;Baillie C;Raggett S;Leech H;Toth R;Goodman N;Keough KC;Lind AL;Zoonomia Consortium;Klesh RJ;Hemphill KR;Carlson-Stevermer J;Oki J;Holden K;Maures T;Pollard KS;Sali A;Agard DA;Cheng Y;Fraser JS;Frost A;Jura N;Kortemme T;Manglik A;Southworth DR;Stroud RM;Alessi DR;Davies P;Frieman MB;Ideker T;Abate C;Jouvenet N;Kochs G;Shoichet B;Ott M;Palmarini M;Shokat KM;García-Sastre A;Rassen JA;Grosse R;Rosenberg OS;Verba KA;Basler CF;Vignuzzi M;Peden AA;Beltrao P;Krogan NJ
通讯作者：
Krogan NJ
影响因子：
14.6
作者：
Schneeweiss, Sebastian;Setoguchi, Soko;Wang, Philip S.
通讯作者：
Wang, Philip S.
影响因子：
13.8
作者：
Ioannou GN;Locke E;Green P;Berry K;O'Hare AM;Shah JA;Crothers K;Eastment MC;Dominitz JA;Fan VS
通讯作者：
Fan VS