51.3 CLINICAL OUTCOME OF COVID-19 PATIENTS WITH AND WITHOUT DIAGNOSED MENTAL HEALTH DISORDER TREATED AT THE LOS ANGELES COUNTY DEPARTMENT OF HEALTH SCIENCE

Abstract

The coronavirus (COVID-19) pandemic is a global public health challenge. It is the source of great stress and anxiety for individuals and communities around the world and has had serious effects in individuals with diagnosed mental disorders. This study compares the all-cause mortality of COVID-19 patients with and without diagnosed mental health disorder (MHD) treated at Los Angeles County Department of Health Science (LAC-DHS). We collected ICD-10 and demographic clinical modification diagnoses in COVID-19 patients in LAC-DHS from March to May 21, 2020 using coded data. Diagnosis codes identified as with and without MHD (F00-99). The relative risk of mortality in COVID-19 patients with and without standardized mean difference (SMD) was calculated. Furthermore, the mortality rate in COVID-19 patients in African American vs other ethnicities was examined. The study protocol was approved by the IRB Committee Board of Olive View-UCLA Education and Research Institute in Sylmar, California. Among 9304 COVID-19 patients treated at LAC-DHS, 37.3% (3475) had an MHD. The mortality rates in COVID-19 patients were 0.36% in patients aged 0 to 17 years, 1.72% in patients 18 to 34, 3.9% in patients 35 to 44, 5.47% in patients 45 to 54, 7.05% in patients 55 to 64, 10.2% in patients 65 to 74, 15.1% in patients 75 to 84, and 19.1% in patients 85+. The total mortality rate of COVID-19 patients without and with an MHD was 5.36% vs 6.82% (p < 0.05). After adjustment for age, regression analysis showed that the relative risk of mortality was 29% (relative risk [RR] = 1.29; 95% CI, 1.1-1.6; p = 0.001) in COVID-19 patients with an MHD compared to those without. Finally, the mortality rate in African American COVID-19 patients was significantly higher (6.72% and 7.6% without and with an MHD, respectively) as compared to other ethnicities. The age-adjusted regression analysis showed that the RR of mortality was 35% (RR = 1.35; 95% CI, 1.25-2.67; p = 0.01) in African American COVID-19 patients with and without MHD, compared to the corresponding groups with other ethnicities. The findings of this study reveal an increased risk of mortality in COVID-19 patients across all ages, which is significantly higher in those with an MHD. Furthermore, the mortality rate was disproportionately higher in African Americans compared to the other ethnicities. In children and adolescents, COVID-19 and its related mortality, while uncommon, are still present.