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.
Subject(s)
COVID-19 , Inpatients , Mental Disorders , Psychotropic Drugs , COVID-19/diagnosis , COVID-19/mortality , COVID-19/psychology , COVID-19/rehabilitation , COVID-19 Nucleic Acid Testing , 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/epidemiologyABSTRACT
The analysis of real-life data from hospital information systems could make possible to decide on the efficacy and safety of Covid-19 treatments by avoiding the pitfalls of preliminary studies and randomized clinical trials. The different drugs tested in current clinical trials are already widely prescribed to patients by doctors in hospitals, and can therefore be immediately analysed according to validated methodological standards.