Mental disorders, psychopharmacological treatments, and mortality in 2150 COVID-19 Spanish inpatients

Acta Psychiatr Scand. 2021 Jun;143(6):526-534. doi: 10.1111/acps.13304. Epub 2021 Apr 13.

Abstract

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.

Keywords: COVID-19; delirium; depressive disorder; mortality; psychopharmacology.

MeSH terms

  • COVID-19 Nucleic Acid Testing
  • COVID-19* / diagnosis
  • COVID-19* / mortality
  • COVID-19* / psychology
  • COVID-19* / rehabilitation
  • Female
  • Hospital Records / statistics & numerical data
  • Hospitalization / statistics & numerical data
  • Humans
  • Inpatients* / psychology
  • Inpatients* / statistics & numerical data
  • Male
  • Mental Disorders* / diagnosis
  • Mental Disorders* / drug therapy
  • Mental Disorders* / epidemiology
  • Mental Disorders* / virology
  • Middle Aged
  • Prognosis
  • Psychotropic Drugs* / classification
  • Psychotropic Drugs* / therapeutic use
  • Recovery of Function
  • Risk Assessment
  • SARS-CoV-2 / isolation & purification
  • Spain / epidemiology

Substances

  • Psychotropic Drugs