COVID-19: A much more severe prognosis in the event of mental disorders

Because the analysis reveals a much more negative prognosis in COVID-19 patients, who also suffer from post-traumatic stress disorder (PTSD). This is also true for patients with other mental illnesses who also have a significantly higher risk of severe disease.

The study is conducted among more than 250,000 veterans who tested positive for COVID between February 2020 and August 2021, with most cases occurring before the vaccine. A total of 6% of veterans died and 15% were hospitalized within 60 days of testing positive. The average age of the participants was over 60 years old and 90% were men. About 26% had PTSD and 28% had another psychiatric diagnosis. The researchers took into account possible confounding factors, including age, gender, race and ethnicity, but also comorbidities including diabetes, cancer and HIV, and cardiovascular, lung, kidney disease. and liver, as well as other factors such as smoking and obesity.

The analysis shows that PTSD is associated, in case of COVID, with:

  • an 8% increased risk of death;

  • a 9% increased risk of hospitalization,
  • in case of other psychiatric disorders, the risk of complications from COVID is also increased:
  • psychosis at a 58% increased risk of death from COVID and a 66% increased risk of hospitalization.
  • bipolar disorder has a 29% and 46% increased risk of death and hospitalization from COVID, respectively,
  • major depression, with increased risks of 13% and 21%, respectively.

Lead author Dr. Kristen Nishimi of UCSF’s Department of Psychiatry notes that PTSD may be milder and better managed in older participants and surprisingly participants with PTSD ‘do’ somewhat better than patients with other psychiatric conditions.

In particular, patients with substance or alcohol use disorders are significantly more likely to be hospitalized for COVID: 62% and 45%, respectively. But their death rates remain about the same as those without a psychiatric diagnosis.

The impact of other comorbidities: the number of deaths and hospitalizations turns out to be significantly higher when the researchers do not take chronic comorbidities into account. This also confirms the key role of these comorbidities in the risk of complications and death from COVID-19.

An unhealthy lifestyle, including physical inactivity, poor diet and smoking, as well as chronic illnesses can contribute to this poor prognosis in patients with PTSD and other mental illnesses.

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