SEARCHMETA-ANALYSISpsychiatry, epidemiology

meta-analysis·psychiatry, epidemiology, infectious disease, systematic review, meta-analysis·PMC10594644

COVID-19 risk, course and outcome in people with mental disorders: a systematic review and meta-analyses

Epidemiology and Psychiatric Sciences · 7 authors, 11 centres

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TL;DR

However, once infected, the course of COVID-19 was relatively severe, with higher odds of hospitalization, long COVID, and death (pooled odds ratios for mortality ranged from 1.26 to 2.57 for most disorders, except anxiety and neurodevelopmental disorders).

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257 CHARS

STUDY TYPE

meta-analysis

SPECIALTY

psychiatry

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ORIGINAL PAPER

PMC10594644

COVID-19 risk, course and outcome in people with mental disorders: a systematic review and meta-analyses

Epidemiology and Psychiatric Sciences

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ABSTRACT

Abstract Aims It has been suggested that people with mental disorders have an elevated risk to acquire severe acute respiratory syndrome coronavirus 2 and to be disproportionally affected by coronavirus disease 19 (COVID-19) once infected. We aimed to analyse the COVID-19 infection rate, course and outcome, including mortality and long COVID, in people with anxiety, depressive, neurodevelopmental, schizophrenia spectrum and substance use disorders relative to control subjects without these disorders. Methods This study constitutes a preregistered systematic review and random-effects frequentist and Bayesian meta-analyses. Major databases were searched up until 27 June 2023. Results Eighty-one original articles were included reporting 304 cross-sectional and prospective effect size estimates (median n per effect-size = 114837) regarding associations of interest. Infection risk was not significantly increased for any mental disorder that we investigated relative to samples of people without these disorders. The course of COVID-19, however, is relatively severe, and long COVID and COVID-19-related hospitalization are more likely in all patient samples that we investigated. The odds of dying from COVID-19 were high in people with most types of mental disorders, except for those with anxiety and neurodevelopmental disorders relative to non-patient samples (pooled ORs range, 1.26–2.57). Bayesian analyses confirmed the findings from the frequentist approach and complemented them with estimates of the strength of evidence. Conclusions Once infected, people with pre-existing mental disorders are at an elevated risk for a severe COVID-19 course and outcome, including long COVID and mortality, relative to people without pre-existing mental disorders, despite an infection risk not significantly increased. Keywords: corona virus disease, COVID-19, disease course, infection risk, long COVID, mental disorders, substance use disorders

CITATION EXPORT

Patricio Molero, Gabriel Reina, Jan Dirk Blom et al.. COVID-19 risk, course and outcome in people with mental disorders: a systematic review and meta-analyses. Epidemiology and Psychiatric Sciences. (2023). https://doi.org/10.1017/S2045796023000719

AUTHORS

7 · 11 CENTRES

Patricio Molero, Gabriel Reina, Jan Dirk Blom, Miguel Ángel Martínez-González, Aischa Reinken, E Ronald de Kloet, Marc L Molendijk

1Department of Psychiatry and Clinical Psychology, Clínica Universidad de Navarra, Pamplona, Spain
2Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
3Department of Microbiology, Clínica Universidad de Navarra, Pamplona, Spain
4Institute of Psychology, Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
5Outpatient Clinic for Uncommon Psychiatric Syndromes, Parnassia Psychiatric Institute, The Hague, The Netherlands
6Department of Psychiatry, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
7Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain
8CIBER-OBN, Instituto de Salud Carlos III, Madrid, Spain
9Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
10Division of Endocrinology, Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands
11Leiden Institute for Brain and Cognition, Leiden University Medical Center, Leiden, The Netherlands