Correlates of Poor Clinical Outcomes Related to COVID-19 Among Older People with Psychiatric Illness - a Mixed Methods Study

Overview

Journal Int J Psychiatry Med

Publisher Sage Publications

Specialty Psychiatry

Date 2023 Aug 2

PMID 37528759

Authors

Surajudeen Abdulrahman

Naser Al-Balushi

Jason Holdcroft-Long

Uzma Khan

Bipin Ravindran

Sujata Das

Anto P Rajkumar

Affiliations

Soon will be listed here.

Abstract

Objective: COVID-19 may lead to a range of clinical outcomes among older people with psychiatric and medical conditions. Evidence guiding management of future outbreaks among this vulnerable population in psychiatric hospital settings are sparse. In this study, we examined the correlates of poor clinical outcomes related to COVID-19 and explored the perspectives of COVID-19 survivors hospitalized in psychiatry settings.

Method: The correlates of poor clinical outcomes related to COVID-19 were examined using a retrospective chart review of 81 older people hospitalized in psychiatry settings. Correlates of clinical outcomes related to COVID-19 were assessed by multiple logistic regression models. In addition, the perspectives of 10 COVID-19 survivors were explored by qualitative interviews. The qualitative data was subject to thematic analysis.

Results: Although 25.9% (n = 21) participants were asymptomatic, there was high COVID-19 related mortality (14.8%; n = 12). Vitamin-D deficiency, anticholinergic burden, and isolation policies within psychiatric wards were significantly ( < 0.05) related to COVID-19 related deaths. In qualitative interviews, participants emphasized the importance of strengthening local support networks and making vaccination centers more accessible.

Conclusions: Reducing anticholinergic prescriptions and improving isolation policies may help to mitigate poor clinical outcomes. Future research investigating the impact of vitamin-D supplementation on COVID-19 related outcomes is warranted.

References

Feiner Solis A, Avedillo Salas A, Luesma Bartolome M, Santander Ballestin S . The Effects of Vitamin D Supplementation in COVID-19 Patients: A Systematic Review. Int J Mol Sci. 2022; 23(20). PMC: 9604062. DOI: 10.3390/ijms232012424. View

Teshome A, Adane A, Girma B, Mekonnen Z . The Impact of Vitamin D Level on COVID-19 Infection: Systematic Review and Meta-Analysis. Front Public Health. 2021; 9:624559. PMC: 7973108. DOI: 10.3389/fpubh.2021.624559. View

Ashique S, Gupta K, Gupta G, Mishra N, Singh S, Wadhwa S . Vitamin D-A prominent immunomodulator to prevent COVID-19 infection. Int J Rheum Dis. 2022; 26(1):13-30. PMC: 9874620. DOI: 10.1111/1756-185X.14477. View

Mehta O, Bhandari P, Raut A, Oussama Kacimi S, Huy N . Coronavirus Disease (COVID-19): Comprehensive Review of Clinical Presentation. Front Public Health. 2021; 8:582932. PMC: 7844320. DOI: 10.3389/fpubh.2020.582932. View

Kummel L, Krumbein H, Fragkou P, Hunerbein B, Reiter R, Papathanasiou K . Vitamin D supplementation for the treatment of COVID-19: A systematic review and meta-analysis of randomized controlled trials. Front Immunol. 2022; 13:1023903. PMC: 9659578. DOI: 10.3389/fimmu.2022.1023903. View

Wynants L, Van Calster B, Collins G, Riley R, Heinze G, Schuit E . Prediction models for diagnosis and prognosis of covid-19: systematic review and critical appraisal. BMJ. 2020; 369:m1328. PMC: 7222643. DOI: 10.1136/bmj.m1328. View

Li X, Wang X, Liu J, Huang G, Shi X . Epidemiological characteristics of confirmed COVID-19 in Guizhou province, China. Disaster Med Public Health Prep. 2020; 14(6):769-775. PMC: 7251290. DOI: 10.1017/dmp.2020.134. View

Bassatne A, Basbous M, Chakhtoura M, El Zein O, Rahme M, Fuleihan G . The link between COVID-19 and VItamin D (VIVID): A systematic review and meta-analysis. Metabolism. 2021; 119:154753. PMC: 7989070. DOI: 10.1016/j.metabol.2021.154753. View

Li L, Li F, Fortunati F, Krystal J . Association of a Prior Psychiatric Diagnosis With Mortality Among Hospitalized Patients With Coronavirus Disease 2019 (COVID-19) Infection. JAMA Netw Open. 2020; 3(9):e2023282. PMC: 7527869. DOI: 10.1001/jamanetworkopen.2020.23282. View

10.

Al Kiyumi M, Kalra S, Davies J, Kalhan A . The Impact of Vitamin D Deficiency on the Severity of Symptoms and Mortality Rate among Adult Patients with Covid-19: A Systematic Review and Meta-Analysis. Indian J Endocrinol Metab. 2022; 25(4):261-282. PMC: 8793953. DOI: 10.4103/ijem.ijem_115_21. View

11.

Shah K, Varna V, Sharma U, Mavalankar D . Does vitamin D supplementation reduce COVID-19 severity?: a systematic review. QJM. 2022; 115(10):665-672. PMC: 9383458. DOI: 10.1093/qjmed/hcac040. View

12.

Zheng Z, Peng F, Xu B, Zhao J, Liu H, Peng J . Risk factors of critical & mortal COVID-19 cases: A systematic literature review and meta-analysis. J Infect. 2020; 81(2):e16-e25. PMC: 7177098. DOI: 10.1016/j.jinf.2020.04.021. View

13.

Schultze A, Nightingale E, Evans D, Hulme W, Rosello A, Bates C . Mortality among Care Home Residents in England during the first and second waves of the COVID-19 pandemic: an observational study of 4.3 million adults over the age of 65. Lancet Reg Health Eur. 2022; 14:100295. PMC: 8743167. DOI: 10.1016/j.lanepe.2021.100295. View

14.

Zuin M, Roncon L, Passaro A, Bosi C, Cervellati C, Zuliani G . Risk of dementia in patients with atrial fibrillation: Short versus long follow-up. A systematic review and meta-analysis. Int J Geriatr Psychiatry. 2021; 36(10):1488-1500. PMC: 8518611. DOI: 10.1002/gps.5582. View

15.

Tilley A, Walters M, Shaykhiev R, Crystal R . Cilia dysfunction in lung disease. Annu Rev Physiol. 2014; 77:379-406. PMC: 4465242. DOI: 10.1146/annurev-physiol-021014-071931. View

16.

Tehrani S, Killander A, Astrand P, Jakobsson J, Gille-Johnson P . Risk factors for death in adult COVID-19 patients: Frailty predicts fatal outcome in older patients. Int J Infect Dis. 2020; 102:415-421. PMC: 7833745. DOI: 10.1016/j.ijid.2020.10.071. View

17.

Ghasemi H, Darvishi N, Salari N, Hosseinian-Far A, Akbari H, Mohammadi M . Global prevalence of polypharmacy among the COVID-19 patients: a comprehensive systematic review and meta-analysis of observational studies. Trop Med Health. 2022; 50(1):60. PMC: 9427437. DOI: 10.1186/s41182-022-00456-x. View

18.

Li G, Liu Y, Jing X, Wang Y, Miao M, Tao L . Mortality risk of COVID-19 in elderly males with comorbidities: a multi-country study. Aging (Albany NY). 2021; 13(1):27-60. PMC: 7835001. DOI: 10.18632/aging.202456. View

19.

Taquet M, Luciano S, Geddes J, Harrison P . Bidirectional associations between COVID-19 and psychiatric disorder: retrospective cohort studies of 62 354 COVID-19 cases in the USA. Lancet Psychiatry. 2020; 8(2):130-140. PMC: 7820108. DOI: 10.1016/S2215-0366(20)30462-4. View

20.

Liu N, Sun J, Wang X, Zhang T, Zhao M, Li H . Low vitamin D status is associated with coronavirus disease 2019 outcomes: a systematic review and meta-analysis. Int J Infect Dis. 2021; 104:58-64. PMC: 7833186. DOI: 10.1016/j.ijid.2020.12.077. View