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Patients with psychiatric disorders are exposed to high risk of COVID-19 and increased mortality. In this study, we set out to assess the clinical features and outcomes of patients with current psychiatric disorders exposed to COVID-19.
This multi-center prospective study was conducted in 22 psychiatric wards dedicated to COVID-19 inpatients between 28 February and 30 May 2020. The main outcomes were the number of patients transferred to somatic care units, the number of deaths, and the number of patients developing a confusional state. The risk factors of confusional state and transfer to somatic care units were assessed by a multivariate logistic model. The risk of death was analyzed by a univariate analysis.
In total, 350 patients were included in the study. Overall, 24 (7%) were transferred to medicine units, 7 (2%) died, and 51 (15%) patients presented a confusional state. Severe respiratory symptoms predicted the transfer to a medicine unit [odds ratio (OR) 17.1; confidence interval (CI) 4.9–59.3]. Older age, an organic mental disorder, a confusional state, and severe respiratory symptoms predicted mortality in univariate analysis. Age >55 (OR 4.9; CI 2.1–11.4), an affective disorder (OR 4.1; CI 1.6–10.9), and severe respiratory symptoms (OR 4.6; CI 2.2–9.7) predicted a higher risk, whereas smoking (OR 0.3; CI 0.1–0.9) predicted a lower risk of a confusional state.
COVID-19 patients with severe psychiatric disorders have multiple somatic comorbidities and have a risk of developing a confusional state. These data underline the need for extreme caution given the risks of COVID-19 in patients hospitalized for psychiatric disorders.
The Critically Endangered Peruvian yellow-tailed woolly monkey Lagothrix flavicauda was presumed to only occur in the tropical montane cloud forests between the Marañón and Huallaga rivers in northern Peru. Here we report the discovery of a population to the south of its previously known range, in the Región Junín. During September–December 2018 we carried out transect surveys to record large mammals present near the village of San Antonio in the district of Pampa Hermosa, at 1,287–2,015 m altitude. We recorded five primate species during transect surveys. Lagothrix flavicauda was seen four times, and appeared phenotypically distinct from populations to the north, with notable white patches above each eye and a reduced yellow patch at the end of the tail. The presence of L. flavicauda in Junín extends its known geographical range over 200 km southwards from the closest previously known population in the Huánuco region, and presents a unique opportunity for the conservation of this Critically Endangered species.