SARS-CoV-2 infection and COVID-19 outcomes across mental disorders and the role of sex: A register-based study from Catalonia
(2024) Psychiatry Research — Vol. 344, n° x, p. 116325 (2024)
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- Introduction This study investigated the risk of SARS-CoV-2 infection and severe COVID-19 outcomes among different mental health diagnoses and the role of sex in these associations. Methods Using electronic records from Catalonia, we identified adults receiving mental health care from 2017–2019 with diagnoses of non-affective psychosis (NAP), bipolar disorder (BD), depressive disorder (DEP), stress-related disorders, neurotic/somatoform disorders (NSD), and substance misuse (SUB) (exposed). The outcomes assessed were SARS-CoV-2 infection, COVID-19 hospitalization, and COVID-19-related death, compared to matched individuals without these mental disorders (unexposed). Adjusted logistic regression analyses were conducted. Results 785,378 adults were included (70.3% < 65 years old; 57.1% women). Compared to unexposed, those with NAP, BD, DEP, and SUB had a lower risk of SARS-CoV-2 infection, while those with NSD had an increased risk. Infected individuals with DEP, NSD, and SUB had a lower risk of hospitalization but a higher risk of COVID-19-related death. Higher COVID-19-related death was also observed in individuals with NAP and BD. Sex-stratified analysis revealed that women with NSD were especially vulnerable to infection, and women with DEP and NSD had a higher risk of COVID-19-related death. Conclusions These findings emphasize the need for tailored public health strategies to reduce excess mortality risk among individuals with certain mental disorders, while accounting for sex differences.
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Monistrol-Mula, A., Giné-Vázquez, I., Caggiu, G., Conflitti, C., Gemes, K., Hecker, I., Mediavilla, R., Compagnoni, M. M., Pinucci, I., Stoffers-Winterling, J., Witteveen, A. B., Smith, P., Walter, H., Ayuso-Mateos, J. L., Melchior, M., Mittendorfer-Rutz, E., Sijbrandij, M., Haro, J. M., & Felez-Nobrega, M. (2024). SARS-CoV-2 infection and COVID-19 outcomes across mental disorders and the role of sex: A register-based study from Catalonia. Psychiatry Research, 344(x), 116325. https://doi.org/10.1016/j.psychres.2024.116325 (Original work published 2024)