PTSD, Other Psychiatric Disorders Linked to Higher Risk of Adverse COVID-19 Outcomes

Patients with posttraumatic stress disorder (PTSD) and other psychiatric disorders had significantly increased risk for hospitalization and death in the 60 days after a positive COVID-19 test, according to a study published in Translational Psychiatry.

“Overall, our data add to an accumulating evidence base that underscores the need to consider patients with psychiatric disorders, including PTSD, as a vulnerable group in the context of the COVID-19 pandemic,” wrote corresponding author Kristen Nishimi, PhD, of the San Francisco Veterans Affairs Health Care System and the University of California San Francisco, and coauthors.

The retrospective cohort study included 228,367 patients from US Department of Veterans Affairs facilities who tested positive for COVID-19 between February 2020 and August 2021. Among them, 25.6% had PTSD, 28.2% had a psychiatric disorder other than PTSD, nearly 90% were male, and 67.4% were White. The average age was 61 years.

According to the study, 15% of patients were hospitalized, and 6% died, in the 60 days following a positive COVID-19 test.

After researchers adjusted for socio-demographics, risks were 1.18 for hospitalization and 1.13 for death in patients with PTSD relative to patients with no psychiatric disorders, the study found. When investigators adjusted for medical comorbidities and smoking, the increased risks remained significant.

Together, patients with PTSD or other psychiatric disorder diagnoses had a 27% increased risk for hospitalization and a 19% increased risk for death after testing positive for COVID-19. Each psychiatric disorder assessed in the study—including major depressive disorder, anxiety, adjustment disorder, alcohol use disorder, substance use disorder, bipolar disorder, and psychotic disorder—was associated with a significantly elevated risk for hospitalization and death from COVID-19.

“The US Centers for Disease Control and Prevention added mood and schizophrenia spectrum disorders to their list of medical conditions that may increase the likelihood of severe COVID-19 illness in October 2021,” researchers wrote. “Our data indicate that PTSD and other psychiatric disorders should be considered for this list as well.”

Reference:
Nishimi K, Neylan TC, Bertenthal D, Dolsen EA, Seal KH, O'Donovan A. Post-traumatic stress disorder and risk for hospitalization and death following COVID-19 infection. Transl Psychiatry. Published online November 22, 2022. doi:10.1038/s41398-022-02156-w