Neuropsychiatric Conditions May Increase Risk of Severe Outcomes from COVID-19

A longitudinal cohort study published in JAMA Psychiatry found that preexisting neuropsychiatric conditions and psychotropic medication use were associated with severe outcomes from COVID-19 infection and severe acute respiratory infections (SARIs).

A prepandemic cohort (n=11,134,789), from January 2015 to January 2020, and a contemporary cohort (n=8,388,956), from January 2020 to March 2021, were compared to evaluate the association between preexisting neuropsychiatric conditions and severe outcomes related to COVID-19 infection and SARIs. Researchers analyzed medical records of people from the United Kingdom with a preexisting neuropsychiatric condition and COVID-19 infection.

Neuropsychiatric conditions, excluding dementia, were associated with an increased risk of poor clinical outcomes from SARI (psychotic disorder diagnosis and treatment: HR, 2.56; 99% CI, 2.40-2.72) and COVID-19 (psychotic disorder treatment: HR, 2.37; 99% CI, 2.20-2.55). Participants with dementia and COVID-19 had a higher risk of poor clinical outcomes than individuals with dementia and SARI (HR, 2.85; 99% CI, 2.71-3.00 vs HR, 2.13; 99% CI, 2.07-2.19). Participants who were prescribed hypnotic, anxiolytic, antidepressant, or antipsychotic medications experienced an increased risk of severe disease from COVID-19 and SARI, regardless of if they had a neuropsychiatric diagnosis.

According to researchers: “These findings suggest the importance of recognizing the association of several neuropsychiatric illnesses with risk of developing a broad range of respiratory infections, not just COVID-19 infection.”

Reference

Ranger TA, Clift AK, Patone M, et al. Preexisting neuropsychiatric conditions and associated risk of severe COVID-19 infection and other acute respiratory infections. JAMA Psychiatry. 2023;80(1):57. doi:10.1001/jamapsychiatry.2022.3614