Comorbidity for psychiatric diseases as determinant in the diagnosis of covid-19 affected patients. Experiences in a hospital at the epicentre of the covid-19 epidemic in italy

Italy has been deeply affected by the outbreak of the novel Sars-CoV-2 coronavirus infection, and the provinces of Brescia and Bergamo in Lombardy paid the highest price in terms of deaths from the disease. The aim of the present article is to retrospectively review the medical records of patients admitted to the Covid-19 medicine unit of an Italian hospital that was at the epicentre of the Covid-19 epidemic, identifying the factors that determined the clinical outcome of the hospitalization. Twenty-one out of 92 subjects (22.8%) admitted to the Covid-19 medicine unit died during the observation period. Compared to subjects who were discharged at home or in rehabilitation or residential facilities, patients who died had more frequently COPD (4.8 vs. 2.8%) and psychiatric diseases (19.5 vs. 7.1%). Duration of symptoms (i.e. fever, dyspnoea) before hospital admission was longer in patients who had an inauspicious outcome (6.3±5.9 vs. 3.5±3, p = 0.021). The logistic regression models (sex and age adjusted) showed a significant increase of risk of death in association with psychiatric disorders (OR = 5.9; CI 95%: 1.1-30.7). Further research should be prompted to investigate potential interactions between psychiatric medications and pathogenetic mechanisms in Covid-19.

Keywords: Covid-19; psychiatric diseases; psychiatric medications; mortality

Lorenzo M. Donini, Giuseppe Colosini, Livio A. Botrugno, Alessandra Romani, Anna Favalli, Andrea Lenzi, Aldo Rosano, Eleonora Poggiogalle, La comorbidità per patologie psichiatriche come determinante della prognosi in pazienti positivi all’infezione da Sars-CoV-2 Esperienza di un ospedale all’epicentro dell’epidemia in Italia in "PSICOBIETTIVO" 2/2020, pp 149-159, DOI: 10.3280/PSOB2020-002012