Psychopharmacotherapy factor in the variants of COVID-19 course in psychiatric inpatients

Abstract

The aim of this study is to examine the relationship between the severity and duration criteria of COVID-19 and the psychopharmacotherapy administered to patients in within a psychiatric hospital.Materials and Methods. We analyzed 169 case histories involving completed clinical cases of COVID-19 treatment in a specialized infectious psychiatric department in St. Petersburg, covering the period from May 2020 to January 2021. Correlation, dispersion, and regression analyses were employed to evaluate severe and mild COVID-19 progression indicators, as well as the duration of persistent SARS-CoV-2 viral shedding. We assessed the clinical and laboratory parameters in patients, along with the psychopharmacotherapy administered, including antidepressants, antipsychotics, and acid sphingomyelinase inhibitors (FIASMA-active drugs).Results. Cardiovascular diseases emerged as a predictor of severe COVID-19 when combined with an increasing platelet-to-lymphocyte ratio (PLR), increasing the risk of severe course by over two-fold. The use of any psychotropic agents was associated with a 0.9% increase in the risk of severe course of COVID-19 for each unit increase in the systemic inflammation index PLR, specifically in patients with intellectual disability (ICD-10 codes F70-79), when compared to patients with schizophrenia (ICD-10 codes F20-29). High PLR values and the use of FIASMA-active drugs were associated with prolonged COVID-19 duration, while antidepressant therapy and elevated C-reactive protein levels were associated with a reduced predicted duration of viral shedding in 13.8% of variance. Additional consideration of the nosology of psychiatric disorders in the regression model increased the proportion of explained variance to 22.8%.Conclusion. Consideration should be given to thymoanaleptic therapy for individuals with psychiatric disorders during periods of increased disease incidence leading up to potential SARS-CoV-2 infection, as it may serve as a protective factor against COVID-19. Furthermore, there is no evidence to suggest adverse effects of antipsychotics on the severity and duration of COVID-19. Further research is required to investigate the effects of FIASMA-active psychopharmacological agents within nosologically homogeneous groups.