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Impact of mental disorders on COVID-19 outcomes

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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.

About the Authors

N. N. Petrova
Saint Petersburg State University
Russian Federation

Department of Psychiatry and Narcology

7/9, Universitetskaya Embankment, Saint Petersburg 199034

V. E. Pashkovskiy
Saint Petersburg State University; V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology, Ministry of Health of Russia
Russian Federation

Vladimir Eduardovich Pashkovskiy

Department of Psychiatry and Narcology

7/9, Universitetskaya Embankment, Saint Petersburg 199034
3, Bekhterev St., Saint Petersburg 192019

M. S. Sivashova
Saint Petersburg State University; St. Petersburg Veterans' Hospital
Russian Federation

Department of Psychiatry and Narcology

7/9, Universitetskaya Embankment, Saint Petersburg 199034
32, Elizarova Pr., Saint Petersburg 192148

A. N. Gvozdetsky
I.I. Mechnikov North-Western State Medical University, Ministry of Health of Russia
Russian Federation

41, Kirochnaya St., Saint Petersburg 191015

G. A. Prokopovich
I.I. Mechnikov North-Western State Medical University, Ministry of Health of Russia
Russian Federation

41, Kirochnaya St., Saint Petersburg 191015


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For citations:

Petrova N.N., Pashkovskiy V.E., Sivashova M.S., Gvozdetsky A.N., Prokopovich G.A. Impact of mental disorders on COVID-19 outcomes. Neurology, Neuropsychiatry, Psychosomatics. 2021;13(5):40-47. (In Russ.)

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