Molecular Biology; Psychiatry and Mental Health; Cellular and Molecular Neuroscience; COVID; Antidepressant
Abstract :
[en] Pre-existing mental disorders are linked to COVID-19-related outcomes. However, the findings are inconsistent and a thorough analysis of a broader spectrum of outcomes such as COVID-19 infection severity, morbidity, and mortality is required. We investigated whether the presence of psychiatric diagnoses and/or the use of antidepressants influenced the severity of the outcome of COVID-19. This retrospective cohort study evaluated electronic health records from the INSIGHT Clinical Research Network in 116,498 individuals who were diagnosed with COVID-19 between March 1, 2020, and February 23, 2021. We examined hospitalization, intubation/mechanical ventilation, acute kidney failure, severe sepsis, and death as COVID-19-related outcomes. After using propensity score matching to control for demographics and medical comorbidities, we used contingency tables to assess whether patients with (1) a history of psychiatric disorders were at higher risk of more severe COVID-19-related outcomes and (2) if use of antidepressants decreased the risk of more severe COVID-19 infection. Pre-existing psychiatric disorders were associated with an increased risk for hospitalization, and subsequent outcomes such as acute kidney failure and severe sepsis, including an increased risk of death in patients with schizophrenia spectrum disorders or bipolar disorders. The use of antidepressants was associated with significantly reduced risk of sepsis (p = 0.033), death (p = 0.026). Psychiatric disorder diagnosis prior to a COVID-19-related healthcare encounter increased the risk of more severe COVID-19-related outcomes as well as subsequent health complications. However, there are indications that the use of antidepressants might decrease this risk. This may have significant implications for the treatment and prognosis of patients with COVID-19.
Disciplines :
Neurosciences & behavior
Author, co-author :
Schultebraucks, Katharina ; Department of Psychiatry, NYU Grossman School of Medicine, New York, NY, USA. Katharina.Schultebraucks@nyulangone.org ; Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA. Katharina.Schultebraucks@nyulangone.org
Blekic, Wivine ; Université de Mons - UMONS ; Department of Psychiatry, NYU Grossman School of Medicine, New York, NY, USA
Basaraba, Cale; Area Mental Health Data Science, New York State Psychiatric Institute, New York, NY, USA
Corbeil, Tom; Area Mental Health Data Science, New York State Psychiatric Institute, New York, NY, USA
Khan, Zain; Department of Biomedical Engineering, Columbia University, New York, NY, USA
Henry, Brandy F; Rehabilitation and Human Services, Educational Psychology, Counseling, and Special Education, College of Education Consortium on Substance Use and Addiction, Social Science Research Institute, Pennsylvania State University, State College, PA, USA
Krawczyk, Noa; Center for Opioid Epidemiology and Policy, Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
Rivera, Bianca D; Center for Opioid Epidemiology and Policy, Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
Allen, Bennett; Center for Opioid Epidemiology and Policy, Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
Arout, Caroline; Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, New York, NY, USA
Pincus, Harold Alan; Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, New York, NY, USA ; Irving Institute for Clinical and Translational Research, Columbia University, New York, NY, USA ; Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
Martinez, Diana M; Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, New York, NY, USA ; Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
Levin, Frances R; Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, New York, NY, USA ; Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
U.S. Department of Health & Human Services | NIH | National Institute of Mental Health U.S. Department of Health & Human Services | NIH | National Heart, Lung, and Blood Institute U.S. Department of Health & Human Services | NIH | National Institute on Drug Abuse U.S. Department of Health & Human Services | NIH | National Institute on Drug Abuse
Funding text :
This work was conducted through use of data from the INSIGHT Clinical Research Network and supported in-part by the Patient-Centered Outcomes Research Institute (PCORI) PCORnet grant to the INSIGHT Clinical Research Network (grant # RI-CRN-2020-004).This publication was supported by the National Center for Advancing Translational Sciences (UL1TR001873). KSs received support from the National Institute of Mental Health (R01MH129856) and the National Heart, Lung, and Blood Institute (R01HL156134). BA received support from the National Institute on Drug Abuse (T32 DA007233). BFH received support from the National Institute on Drug Abuse (T32DA037801). FRL receives grant support from the NIDA, NCATS, SAMHSA, US World Meds and research support from Aelis Pharmaceuticals. She also receives medication from Indivior for research and royalties from APA publishing. In addition, FRL served as a nonpaid member of a Scientific Advisory Board for Alkermes, Indivior, Novartis, Teva, and US WorldMeds and is a consultant to Major League Baseball. DM received support from the National Institute on Drug Abuse (K24 DA050087). HAP is employed by Columbia University, New York State Office of Mental Health/Research, Foundation for Mental Hygiene, and RAND Corporation (Adjunct Staff). All research and training projects funded by not for profit or public sources. He has served on clinical advisory committees for AbleTo, Cerebral and Magellan Studio. NK is involved in ongoing opioid litigation. All other authors report no conflict of interest.
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