Longer-term mortality following SARS-CoV-2 infection in people with severe mental illness: retrospective case-matched study.

Shanquan Chen,Emilio Fernandez-Egea,Rudolf N Cardinal,Peter B Jones,Jonathan R Lewis

doi:10.1192/bjo.2021.1046

Abstract

Persisting symptoms and dysfunction after SARS-CoV-2 infection have frequently been observed. However, information on the aftermath of COVID-19 is inadequate. We followed up people with severe mental illness (SMI) infected with SARS-CoV-2, and evaluated their longer-term mortality, using data from Cambridgeshire and Peterborough NHS Foundation Trust, UK. We examined the time course and duration of mortality risk from the point of diagnosis. After SARS-CoV-2 infection, people with SMI had a substantially higher risk of death (hazard ratio (HR) = 5.16, 95% confidence interval (CI) 1.56-17.03; P = 0.007) during the first 28 days and during the following 28-60 days (HR = 2.96, 95% CI 1.21-7.26; P = 0.018) than those without infection, but after 60 days the additional risk of death was no longer significant (HR = 2.33, 95% CI 0.83-6.53; P = 0.107).

Highlights

Persisting symptoms and dysfunction after SARS-CoV-2 infection have frequently been observed
SARS-CoV-2 status was confirmed by the reverse transcription polymerase chain reaction (RT-PCR) test recommended by the World Health Organization (WHO)
Between 1 March 2020 and 28 February 2021, a total of 121 individuals with severe mental illness (SMI) and infected with SARS-CoV-2 were included in the exposure cohort, and 1210 individuals with SMI without SARS-CoV-2 infection were matched from 22 048 individuals with SMI and included in the control cohort

Summary

Introduction

Persisting symptoms and dysfunction after SARS-CoV-2 infection have frequently been observed. Information on the aftermath of COVID-19 is inadequate. We followed up people with severe mental illness (SMI) infected with SARS-CoV-2, and evaluated their longer-term mortality, using data from Cambridgeshire and Peterborough NHS Foundation Trust, UK. We examined the time course and duration of mortality risk from the point of diagnosis. After SARS-CoV-2 infection, people with SMI had a substantially higher risk of death (hazard ratio (HR) = 5.16, 95% confidence interval (CI) 1.56–17.03; P = 0.007) during the first 28 days and during the following 28–60 days (HR = 2.96, 95% CI 1.21–7.26; P = 0.018) than those without infection, but after 60 days the additional risk of death was no longer significant (HR = 2.33, 95% CI 0.83–6.53; P = 0.107)

Methods

Results

Discussion

Conclusion