Open AccessImpact of mental disorders on COVID-19 outcomes
Author(s) -
Н. Petrova,
V. E. Pashkovskiy,
М. С. Сивашова,
A. Gvozdetsky,
Г. А. Прокопович
Publication year - 2021
Publication title -
nevrologiâ, nejropsihiatriâ, psihosomatika
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.157
H-Index - 9
eISSN - 2310-1342
pISSN - 2074-2711
DOI - 10.14412/2074-2711-2021-5-40-47
Subject(s) - medicine , hazard ratio , confidence interval , proportional hazards model , delirium , logistic regression , prospective cohort study , mental state , psychiatry
Objective : to analyze clinical and follow-up indicators in patients with mental disorders and COVID-19 and to identify on their basis predictors of poor outcomes associated with mental state. Patients and methods . We conducted a prospective study in a multidisciplinary hospital. The severity of coronavirus infection was determined according to the temporary guidelines. Data collection was carried out using a patient chart consisting of 109 variables. Predictors of poor outcomes were determined using predictive models (logit regression, Cox model). The study included 97 patients: 41 men (42.3%) and 56 (57.7%) women, mean age – 62.3±15.3 years. 26 patients died; 71 patients recovered. Results and discussion . The death occurred on 11.5 day. The mental state of these patients was severe, with a predominance of delirium cases. With increasing age, the probability of non-lethal outcome decreases [hazard ratio (HR) 1.03; 95% confidence interval (CI) 1.00–1.06; p=0.037]. The risk of death increased by 1.03 (p=0.037) for each year of life. An improvement in the mental state of patients during psychotropic therapy is associated with an 11.11-fold decrease in the risk of poor outcome of coronavirus infection (HR 0.09; 95% CI 0.01–0.76; p=0.027). Delirium is a predictor of low patient survival, especially in prolonged hospitalizations (HR 4.55; 95% CI 1.66–12.48; p=0.003). The severity of coronavirus infection makes the greatest contribution to the poor outcome: the risk of death increases by 33.17 times (CR 33.17; 95% CI 4.01–274.65; p<0.001). The severity of the mental disorder had a greater impact on the risk of death compared with age, increasing it by 4.55 times (p=0.003). Conclusion . We found significant differences between the groups of deceased and surviving patients with COVID-19 concerning the variables related to certain mental disorders, their severity and dynamics, and the severity of coronavirus infection. In addition, the age of the patients had a significant impact on the prognosis of COVID-19. The results reflect the special prognostic significance of delirium in the structure of mental disorders developing in patients with coronavirus infection.