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Mortality among inpatients with bipolar disorders and COVID-19: a propensity score matching analysis in a national French cohort study

Published online by Cambridge University Press:  24 August 2021

Guillaume Fond*
Affiliation:
CEReSS-Health Service Research and Quality of Life Center, Aix-Marseille University, 27 Boulevard Jean Moulin, Marseille 13005, France FondaMental Academic Advanced Center of Expertise for Bipolar Disorders and Schizophrenia (FACE-BD, FACE-SZ), Créteil, France
Vanessa Pauly
Affiliation:
CEReSS-Health Service Research and Quality of Life Center, Aix-Marseille University, 27 Boulevard Jean Moulin, Marseille 13005, France
Marc Leone
Affiliation:
Assistance Publique Hôpitaux Universitaires de Marseille, Aix-Marseille University, Hôpital Nord, Service d'Anesthésie et de Réanimation, Marseille, France
Veronica Orleans
Affiliation:
CEReSS-Health Service Research and Quality of Life Center, Aix-Marseille University, 27 Boulevard Jean Moulin, Marseille 13005, France
Alexandra Garosi
Affiliation:
CEReSS-Health Service Research and Quality of Life Center, Aix-Marseille University, 27 Boulevard Jean Moulin, Marseille 13005, France
Christophe Lancon
Affiliation:
CEReSS-Health Service Research and Quality of Life Center, Aix-Marseille University, 27 Boulevard Jean Moulin, Marseille 13005, France FondaMental Academic Advanced Center of Expertise for Bipolar Disorders and Schizophrenia (FACE-BD, FACE-SZ), Créteil, France
Pascal Auquier
Affiliation:
CEReSS-Health Service Research and Quality of Life Center, Aix-Marseille University, 27 Boulevard Jean Moulin, Marseille 13005, France
Karine Baumstarck
Affiliation:
CEReSS-Health Service Research and Quality of Life Center, Aix-Marseille University, 27 Boulevard Jean Moulin, Marseille 13005, France
Pierre-Michel Llorca
Affiliation:
FondaMental Academic Advanced Center of Expertise for Bipolar Disorders and Schizophrenia (FACE-BD, FACE-SZ), Créteil, France CMP-B, CHU, CNRS, Clermont Auvergne INP, Institut Pascal, Université Clermont Auvergne, F-63000 Clermont-Ferrand, France
Laurent Boyer
Affiliation:
CEReSS-Health Service Research and Quality of Life Center, Aix-Marseille University, 27 Boulevard Jean Moulin, Marseille 13005, France FondaMental Academic Advanced Center of Expertise for Bipolar Disorders and Schizophrenia (FACE-BD, FACE-SZ), Créteil, France
*
Author for correspondence: Guillaume Fond, E-mail: guillaume.fond@ap-hm.fr

Abstract

Background

It remains unknown whether coronavirus disease 2019 (COVID-19) patients with bipolar disorders (BDs) are at an increased risk of mortality. We aimed to establish whether health outcomes and care differed between patients infected with COVID-19 with BD and patients without a diagnosis of severe mental illness.

Methods

We conducted a population-based cohort study of all patients with identified COVID-19 and respiratory symptoms who were hospitalized in France between February and June 2020. The outcomes were in-hospital mortality and intensive care unit (ICU) admission. We used propensity score matching to control for confounding factors.

Results

In total, 50 407 patients were included, of whom 480 were patients with BD. Patients with BD were 2 years older, more frequently women and had more comorbidities than controls without a diagnosis of severe mental illness. Patients with BD had an increased in-hospital mortality rate (26.6% v. 21.9%; p = 0.034) and similar ICU admission rate (27.9% v. 28.4%, p = 0.799), as confirmed by propensity analysis [odds ratio, 95% confidence interval (OR, 95% CI) for mortality: 1.30 (1.16–1.45), p < 0.0001]. Significant interactions between BD and age and between BD and social deprivation were found, highlighting that the most important inequalities in mortality were observed in the youngest [OR, 95% CI 2.28 (1.18–4.41), p = 0.0015] and most deprived patients with BD [OR, 95% CI 1.60 (1.33–1.92), p < 0.001].

Conclusions

COVID-19 patients with BD were at an increased risk of mortality, which was exacerbated in the youngest and most deprived patients with BD. Patients with BD should thus be targeted as a high-risk population for severe forms of COVID-19, requiring enhanced preventive and disease management strategies.

Type
Original Article
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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