PCN reports : psychiatry and clinical neurosciences · 2025
A retrospective risk factor analysis in psychiatric inpatients with COVID-19 from 2020 to 2023 at a neuropsychiatric hospital in Tokyo.
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Inagawa Takuma, Ariga Hajime, Okano Hiroki, Enokida Takako, Usami Takashi, Unuma Atsushi, Saitoh Yuji, Satake Naoko, Noda Takamasa
Аннотация
AIM: To identify the factors associated with the severity and prognosis of coronavirus disease 2019 (COVID-19) in patients with psychiatric or neurological disorders.
METHODS: We retrospectively analyzed the clinical characteristics and treatment outcomes of 349 patients with those disorders who were admitted for COVID-19 at the National Center of Neurology and Psychiatry between June 2020 and March 2023. The study period was divided into three phases: June-December 2020, January-December 2021, and January 2022 to March 2023 according to the differences in types of COVID-19 variants and our clinical care systems. Differences across phases were analyzed using the Kruskal-Wallis test. Logistic regression was performed to identify factors associated with moderate II or higher COVID-19 and all-cause mortality.
RESULTS: A total of 36 (10.3%), 107 (30.7%), and 206 (59.0%) patients were admitted in the first, second, and third phases, respectively. The average age of the patients was 66.4 ± 17.9 years, and 47% of them were female. Aspiration pneumonia complicated by COVID-19 was strongly associated with moderate II or higher (odds ratio [OR] = 10.871, p < 0.001), antipsychotics (OR = 1.947, p = 0.034), transfer from psychiatric hospitals (OR = 2.878, p = 0.006), and older age (≥65 years, OR = 4.467, p < 0.001) were significant risk factors for moderate II or higher COVID-19. Moderate II or higher COVID-19 significantly predicted all-cause mortality (OR = 32.658, p = 0.001). Phase-stratified analyses indicated that older age (Phase 2: OR 3.69; Phase 3: OR 4.75) and aspiration pneumonia (Phase 3: OR 13.9) were consistently associated with moderate II or higher COVID-19, whereas the association with antipsychotic use was phase-dependent (significant in Phase 2: OR 4.74, but not in Phase 3: OR 1.12).
CONCLUSION: These findings suggest that patients with psychiatric disorders, particularly elderly individuals or those with aspiration pneumonia, are associated with moderate II or higher COVID-19. Further prospective observational studies are warranted.
METHODS: We retrospectively analyzed the clinical characteristics and treatment outcomes of 349 patients with those disorders who were admitted for COVID-19 at the National Center of Neurology and Psychiatry between June 2020 and March 2023. The study period was divided into three phases: June-December 2020, January-December 2021, and January 2022 to March 2023 according to the differences in types of COVID-19 variants and our clinical care systems. Differences across phases were analyzed using the Kruskal-Wallis test. Logistic regression was performed to identify factors associated with moderate II or higher COVID-19 and all-cause mortality.
RESULTS: A total of 36 (10.3%), 107 (30.7%), and 206 (59.0%) patients were admitted in the first, second, and third phases, respectively. The average age of the patients was 66.4 ± 17.9 years, and 47% of them were female. Aspiration pneumonia complicated by COVID-19 was strongly associated with moderate II or higher (odds ratio [OR] = 10.871, p < 0.001), antipsychotics (OR = 1.947, p = 0.034), transfer from psychiatric hospitals (OR = 2.878, p = 0.006), and older age (≥65 years, OR = 4.467, p < 0.001) were significant risk factors for moderate II or higher COVID-19. Moderate II or higher COVID-19 significantly predicted all-cause mortality (OR = 32.658, p = 0.001). Phase-stratified analyses indicated that older age (Phase 2: OR 3.69; Phase 3: OR 4.75) and aspiration pneumonia (Phase 3: OR 13.9) were consistently associated with moderate II or higher COVID-19, whereas the association with antipsychotic use was phase-dependent (significant in Phase 2: OR 4.74, but not in Phase 3: OR 1.12).
CONCLUSION: These findings suggest that patients with psychiatric disorders, particularly elderly individuals or those with aspiration pneumonia, are associated with moderate II or higher COVID-19. Further prospective observational studies are warranted.