Mortality in association with antipsychotic medication use and clinical outcomes among geriatric psychiatry outpatients with COVID-19.

<h4>Objectives</h4>Older adults are particularly vulnerable to the negative consequences of antipsychotic exposure and are disproportionally affected by higher mortality from coronavirus disease 2019 (COVID-19). Our goal was to determine whether concurrent antipsychotic medication use wa...

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Autores principales:	Bienvenida Austria, Rehana Haque, Sukriti Mittal, Jamie Scott, Aninditha Vengassery, Daniel Maltz, Wentian Li, Blaine Greenwald, Yun Freudenberg-Hua
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/ab1a56a3306c48df9aa1a44df3b1d5e9
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spelling	oai:doaj.org-article:ab1a56a3306c48df9aa1a44df3b1d5e92021-12-02T20:07:48ZMortality in association with antipsychotic medication use and clinical outcomes among geriatric psychiatry outpatients with COVID-19.1932-620310.1371/journal.pone.0258916https://doaj.org/article/ab1a56a3306c48df9aa1a44df3b1d5e92021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0258916https://doaj.org/toc/1932-6203<h4>Objectives</h4>Older adults are particularly vulnerable to the negative consequences of antipsychotic exposure and are disproportionally affected by higher mortality from coronavirus disease 2019 (COVID-19). Our goal was to determine whether concurrent antipsychotic medication use was associated with increased COVID-19 mortality in older patients with preexisting behavioral health problems. We also report on findings from post-COVID follow-ups.<h4>Design</h4>Retrospective observational study.<h4>Participants</h4>Outpatients at a geriatric psychiatric clinic in New York City.<h4>Measurements</h4>Demographic and clinical data including medication, diagnosis and Clinical Global Impression Severity (CGI-S) scales on outpatients who had COVID-19 between February 28th and October 1st 2020 were extracted from the electronic health records (EHR) from the hospital.<h4>Results</h4>A total of 56 patients were diagnosed with COVID-19 (mean age 76 years; median age 75 years) and 13 (23.2%) died. We found an increased mortality risk for patients who were prescribed at least one antipsychotic medication at the time of COVID-19 infection (Fisher's exact test P = 0.009, OR = 11.1, 95% confidence interval: 1.4-96.0). This result remains significant after adjusting for age, gender, housing context and dementia (Logistic regression P = 0.035, Beta = 2.4). Furthermore, we found that most patients who survived COVID-19 (88.4%) recovered to pre-COVID baseline in terms of psychiatric symptoms. Comparison of pre- and post-COVID assessments of CGI-S for 33 patients who recovered from COVID-19 were not significantly different.<h4>Conclusion</h4>We observed a higher COVID-19 mortality associated with concurrent antipsychotics use in older patients receiving behavioral health services. The majority of patients in our geriatric clinic who recovered from COVID-19 appeared to return to their pre-COVID psychiatric function. More precise estimates of the risk associated with antipsychotic treatment in older patients with COVID-19 and other underlying factors will come from larger datasets and meta-analyses.Bienvenida AustriaRehana HaqueSukriti MittalJamie ScottAninditha VengasseryDaniel MaltzWentian LiBlaine GreenwaldYun Freudenberg-HuaPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 10, p e0258916 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Bienvenida Austria Rehana Haque Sukriti Mittal Jamie Scott Aninditha Vengassery Daniel Maltz Wentian Li Blaine Greenwald Yun Freudenberg-Hua Mortality in association with antipsychotic medication use and clinical outcomes among geriatric psychiatry outpatients with COVID-19.
description	<h4>Objectives</h4>Older adults are particularly vulnerable to the negative consequences of antipsychotic exposure and are disproportionally affected by higher mortality from coronavirus disease 2019 (COVID-19). Our goal was to determine whether concurrent antipsychotic medication use was associated with increased COVID-19 mortality in older patients with preexisting behavioral health problems. We also report on findings from post-COVID follow-ups.<h4>Design</h4>Retrospective observational study.<h4>Participants</h4>Outpatients at a geriatric psychiatric clinic in New York City.<h4>Measurements</h4>Demographic and clinical data including medication, diagnosis and Clinical Global Impression Severity (CGI-S) scales on outpatients who had COVID-19 between February 28th and October 1st 2020 were extracted from the electronic health records (EHR) from the hospital.<h4>Results</h4>A total of 56 patients were diagnosed with COVID-19 (mean age 76 years; median age 75 years) and 13 (23.2%) died. We found an increased mortality risk for patients who were prescribed at least one antipsychotic medication at the time of COVID-19 infection (Fisher's exact test P = 0.009, OR = 11.1, 95% confidence interval: 1.4-96.0). This result remains significant after adjusting for age, gender, housing context and dementia (Logistic regression P = 0.035, Beta = 2.4). Furthermore, we found that most patients who survived COVID-19 (88.4%) recovered to pre-COVID baseline in terms of psychiatric symptoms. Comparison of pre- and post-COVID assessments of CGI-S for 33 patients who recovered from COVID-19 were not significantly different.<h4>Conclusion</h4>We observed a higher COVID-19 mortality associated with concurrent antipsychotics use in older patients receiving behavioral health services. The majority of patients in our geriatric clinic who recovered from COVID-19 appeared to return to their pre-COVID psychiatric function. More precise estimates of the risk associated with antipsychotic treatment in older patients with COVID-19 and other underlying factors will come from larger datasets and meta-analyses.
format	article
author	Bienvenida Austria Rehana Haque Sukriti Mittal Jamie Scott Aninditha Vengassery Daniel Maltz Wentian Li Blaine Greenwald Yun Freudenberg-Hua
author_facet	Bienvenida Austria Rehana Haque Sukriti Mittal Jamie Scott Aninditha Vengassery Daniel Maltz Wentian Li Blaine Greenwald Yun Freudenberg-Hua
author_sort	Bienvenida Austria
title	Mortality in association with antipsychotic medication use and clinical outcomes among geriatric psychiatry outpatients with COVID-19.
title_short	Mortality in association with antipsychotic medication use and clinical outcomes among geriatric psychiatry outpatients with COVID-19.
title_full	Mortality in association with antipsychotic medication use and clinical outcomes among geriatric psychiatry outpatients with COVID-19.
title_fullStr	Mortality in association with antipsychotic medication use and clinical outcomes among geriatric psychiatry outpatients with COVID-19.
title_full_unstemmed	Mortality in association with antipsychotic medication use and clinical outcomes among geriatric psychiatry outpatients with COVID-19.
title_sort	mortality in association with antipsychotic medication use and clinical outcomes among geriatric psychiatry outpatients with covid-19.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/ab1a56a3306c48df9aa1a44df3b1d5e9
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Mortality in association with antipsychotic medication use and clinical outcomes among geriatric psychiatry outpatients with COVID-19.

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