4.6 Article

Mood Disorders and Outcomes of COVID-19 Hospitalizations

Journal

AMERICAN JOURNAL OF PSYCHIATRY
Volume 178, Issue 6, Pages 541-547

Publisher

AMER PSYCHIATRIC PUBLISHING, INC
DOI: 10.1176/appi.ajp.2020.20060842

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Funding

  1. NIH [R01MH120227, R01MH116270]
  2. Brain and Behavior Research Foundation
  3. National Human Genome Research Institute
  4. National Institute of Nursing Research
  5. Stanley Center at the Broad Institute
  6. NIMH
  7. Telefonica Alfa

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The study found that COVID-19 patients with a history of mood disorders may face increased risk of morbidity and mortality in the hospital, as well as a higher likelihood of needing post-acute care. Further research should investigate the mechanisms by which these disorders may contribute to elevated risk.
Objective: The authors sought to characterize the association between prior mood disorder diagnosis and hospital outcomes among individuals admitted with COVID-19 to six Eastern Massachusetts hospitals. Methods: A retrospective cohort was drawn from the electronic health records of two academic medical centers and four community hospitals between February 15 and May 24, 2020. Associations between history of mood disorder and in-hospital mortality and hospital discharge home were examined using regression models among any hospitalized patients with positive tests for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Results: Among 2,988 admitted individuals, 717 (24.0%) had a prior mood disorder diagnosis. In Cox regression models adjusted for age, sex, and hospital site, presence of a mood disorder prior to admission was associated with greater in-hospital mortality risk beyond hospital day 12 (crude hazard ratio=2.156, 95% CI=1.540, 3.020; fully adjusted hazard ratio=1.540, 95% CI=1.054, 2.250). A mood disorder diagnosis was also associated with greater likelihood of discharge to a skilled nursing facility or other rehabilitation facility rather thanhome(crudeodds ratio=2.035,95% CI=1.661, 2.493; fully adjusted odds ratio=1.504, 95% CI=1.132, 1.999). Conclusions: Hospitalized individuals with a history of mood disorder may be at risk for greater COVID-19 morbidity and mortality and are at increased risk of need for postacute care. Further studies should investigate the mechanism by which these disorders may confer elevated risk.

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