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Abstract

Introduction: Coronavirus (COVID-19) infection has spread globally and resulted in more than one million deaths in the US as of July 2023, where it has been more severe in psychiatric wards. State hospitals are a particularly transmissible location for COVID-19, and the medications that psychiatric patients typically utilize may contribute to the incidence of comorbidities including obesity, hypertension, and diabetes. Studies have found that patients with preexisting mental health disorders and comorbidities tend to have worse COVID-19 outcomes. Thus, we examine the mortality and comorbidity rate of patients, and discuss how psychiatric medications may contribute to the risk of COVID-19 outcomes for psychiatric patients in a state hospital.

Methods: We performed a retrospective study on 24 patients in a psychiatric state hospital who are above 18 years old, tested positive for COVID-19, and experienced symptoms severe enough to be admitted to a community hospital between April 1, 2020, to June 30, 2022. Patients with multiple COVID-19 admissions to the hospital during this period were excluded if the period between admissions was less than two weeks.

Results: The patients had an average (IQR) age of 57.75 (48-64) and 2.12 (2-3) comorbidities. The most common psychiatric disorders were schizoaffective disorder (70.8%), schizophrenia (29.2%), and delirium (29.2%). For comorbidities, patients most commonly presented with hypertension (54.2%), chronic kidney disease (41.2%), diabetes (33.3%), and obesity (33.3%) upon admission. The most common psychiatric medications during admission for COVID-19 were antipsychotics (83.3%), mood stabilizers (54.2%), and antidepressants (54.2%).

Conclusion: Though our study is qualitative in nature, it is meant to shed light on conditions that may precipitate the worsening of COVID-19 infection in hospitalized psychiatric patients. We recommend additional studies in order to have a comprehensive understanding of the extent to which psychiatric medications result in worse COVID-19 outcomes due to comorbidities.

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