Mental disorders and covid-19 mortality

Mental disorders and covid-19 mortality

Publication date: 27-08-2021

Updated on: 14-02-2023

Topic: Covid-19

Estimated reading time: 1 min

A meta-analysis conducted by researchers from San Raffaele accentuates higher mortality from COVID-19 in patients with mental disorders

Pre-existing mental disorders, such as psychotic and mood disorders, substance abuse, intellectual disabilities, and developmental disorders, can be a risk factor for a more severe course of COVID-19.

This association is confirmed by an international team coordinated by Dr. Benedetta Vai and Dr. Mario Gennaro Mazza, researchers of the Psychiatry and Clinical Psychobiology Unit led by Francesco Benedetti, associate professor of the Vita-Salute San Raffaele University. Research was conducted with a collaboration of Livia J. De Picker, psychiatrist at the University Psychiatric Hospital Campus Duffel of Belgium.

In a meta-analysis published in The Lancet Psychiatry, researchers investigated mortality risk from COVID-19, hospitalization rates and ICU admission in patients with mental disorders. Results highlighted increased risk of severe events associated with COVID-19 and therefore the need for preventive targeted approaches towards these individuals.

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In the meta-analysis were included 23 studies conducted from January 2020 to March 2021 with a total population of 1,469,731 COVID-19 patients from 22 countries. 43,938 patients had mental disorders such as psychotics, mood and anxiety disorders, substance abuse, intellectual disabilities, and developmental disorders.

“Our primary purpose was to analyze the data to determine the mortality risk related to COVID-19 in psychiatric patients. Subsequently, we also assessed the risks of hospitalization and intensive care admission in these patients”, explains Dr. Vai.

Results among people with anxiety disorders fully confirmed that patients with mental disorders (in particular, with psychotic and mood disorders) have a greater risk of mortality, but not of admission to intensive care units.

Possible causes

Researchers had put forward several hypotheses underlying association between mental disorders and increased risk of mortality from COVID-19. On the one hand, the immune-inflammatory alterations linked to the pathophysiological bases of psychiatric diseases, on the other a greater prevalence of comorbidities (obesity, diabetes, metabolic syndrome, and cardiovascular diseases) and unhealthy lifestyles (diet, physical inactivity, alcohol and tobacco abuse, sleep disorders), associated with psychiatric diseases and their need for drug treatment, which can lead to a more rapid course of the disease.

Furthermore, the analysis highlights that increase in mortality accompanied by reduced rates of hospitalization in intensive care may also reflect lower access rate to necessary care.

Change of perspective

“These results demonstrate the need for targeted approaches for the management and prevention of COVID-19 in patients with mental disorders”, explains Professor Benedetti.

Together with Dr. Vai, Professor Benedetti participated in a study signed by the main European organizations for the mental health, in which coordinated action was requested to ensure vaccination priority in psychiatric patients. The study was also published on the pages of The Lancet Psychiatry.

“Today it is important to take care of these patients and to assess their needs for particular attention from local authorities to get the access to vaccination and to hospital treatment”, concludes Dr. Mazza.

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