Those with psychosis had a 58% increased risk of death associated with COVID-19, and those with bipolar disorder had a 29% increased risk of dying from coronavirus.A new study shows that patients with COVID-19 who also had post-traumatic stress disorder (PTSD) were more likely to die or be hospitalized than those without a psychiatric disorder.Researchers from UC San Francisco and the San Francisco VA Health Care System have found that veterans with PTSD had an 8% increased risk of death if they had COVID and a 9% increased risk of hospitalization, compared with patients with the virus and without a psychiatric diagnosis, adjusting for age, sex, race and co-occurring medical conditions.Those with psychosis had a 58% increased risk of death and a 66% increased risk of hospitalization, relative to those without psychiatric diagnoses, the researchers reported in their study, publishing in Translational Psychiatry on Nov.For those with bipolar disorder, the increased risks of death and hospitalization were 29% and 46%, respectively; and for major depression, they were 13% and 21%, respectively.Surprisingly, the PTSD group fared better than patients with all other psychiatric disorders, which also included adjustment disorder, anxiety, and alcohol use and substance use disorders.“Older veterans, who may have been diagnosed with PTSD many years ago and have chronic PTSD, may have symptoms that are relatively less severe or better managed,” she said, noting that PTSD in patients under 65 with COVID yielded worse outcomes than in older patients (16% higher risk of hospitalization compared with 6% for the 65-plus cohort).
But mortality rates were about the same as those without a psychiatric diagnosis, indicating that lack of caregiver or social support, and an increased incidence of homelessness could be driving these higher hospitalization rates.
For example, when patients with PTSD were compared to those without psychiatric disorders, solely adjusting for age, sex, race and ethnicity, they had an 13% higher risk of death from COVID.“While other psychiatric conditions have been linked to comorbidities, inflammation and health risk behaviors, PTSD in particular is characterized by lower levels of the stress hormone cortisol, which has anti-inflammatory properties that may be beneficial in reducing the inflammatory activity that underlies many adverse outcomes of COVID.”.In this retrospective cohort study, we examined associations of PTSD and other psychiatric disorders with risk for hospitalization and death in the 60 days following a COVID-19 infection in 228,367 U.SAmong 228,367 VA patients, 25.6% had PTSD, and 28.2% had a psychiatric disorder other than PTSD
Patients with PTSD had an increased risk for both hospitalization (adjusted relative risk, ARR = 1.18, 95% CI 1.15–1.21) and death (ARR = 1.13, 95% CI 1.08–1.19) relative to those with no psychiatric disorders, adjusting for socio-demographics
Patients with other psychiatric disorders also had an increased risk of adverse COVID-19 outcomes, with larger effect sizes than PTSD in older (≥65 years) but not younger patientsIn this large-scale study of VA patients, individuals with PTSD, and other psychiatric disorders, had heightened vulnerability to severe adverse outcomes of COVID-19; thus, individuals with PTSD should also be considered at higher risk for severe COVID-19 outcomes, and potentially prioritized for vaccination, screening, and early treatment intervention for COVID-19