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Pintos-Rodríguez S, Visos-Varela I, Rodríguez-Fernández A, Zapata-Cachafeiro M, Piñeiro-Lamas M, Herdeiro MT, García-Álvarez RM, Figueiras A, Salgado-Barreira Á. Outpatient Antipsychotic Use and Severe COVID-19: Avoiding the Impact of Age in a Real-World Data Study. Int J Neuropsychopharmacol 2024; 27:pyae020. [PMID: 38600711 PMCID: PMC11059787 DOI: 10.1093/ijnp/pyae020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 04/10/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND The association between use of antipsychotics and COVID-19 outcomes is inconsistent, which may be linked to use of these drugs in age-related diseases. Furthermore, there is little evidence regarding their effect in the nongeriatric population. We aim to assess the association between antipsychotic use and risk of disease progression and hospitalization due to COVID-19 among the general population, stratifying by age. METHODS We conducted a population-based, multiple case-control study to assess risk of hospitalization, with cases being patients with a PCR(+) test who required hospitalization and controls being individuals without a PCR(+) test; and risk of progression to hospitalization, with cases being the same as those used in the hospitalization substudy and controls being nonhospitalized PCR(+) patients. We calculated adjusted odds-ratios (aOR) and 95% confidence intervals (CI), both overall and stratified by age. RESULTS Antipsychotic treatment in patients younger than 65 years was not associated with a higher risk of hospitalization due to COVID-19 (aOR 0.94 [95%CI = 0.69-1.27]) and disease progression among PCR(+) patients (aOR 0.96 [95%CI = 0.70-1.33]). For patients aged 65 years or older, however, there was a significant, increased risk of hospitalization (aOR 1.58 [95% CI = 1.38-1.80]) and disease progression (aOR 1.31 [95% CI = 1.12-1.55]). CONCLUSIONS The results of our large-scale real-world data study suggest that antipsychotic use is not associated with a greater risk of hospitalization due to COVID-19 and progression to hospitalization among patients younger than 65 years. The effect found in the group aged 65 years or older might be associated with off-label use of antipsychotics.
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Affiliation(s)
- Samuel Pintos-Rodríguez
- Department of Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Irene Visos-Varela
- Department of Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Almudena Rodríguez-Fernández
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiology and Public Health - CIBERESP), Madrid, Spain
- Department of Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Maruxa Zapata-Cachafeiro
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiology and Public Health - CIBERESP), Madrid, Spain
- Department of Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - María Piñeiro-Lamas
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - María Teresa Herdeiro
- Department of Medical Sciences, iBiMED-Institute of Biomedicine, University of Aveiro, Aveiro, Portugal
| | - Rosa María García-Álvarez
- Santiago de Compostela Health Area, Galician Health Service (Servizo Galego de Saúde - SERGAS), Santiago de Compostela, Spain
- Department of Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Adolfo Figueiras
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiology and Public Health - CIBERESP), Madrid, Spain
- Department of Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Ángel Salgado-Barreira
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiology and Public Health - CIBERESP), Madrid, Spain
- Department of Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
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2
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Tendilla-Beltrán H, Carbajal-Rimoldi LA, Flores F, Gómez-Mendoza LE, Loaiza G, Flores G. Antipsychotics modified COVID-19 prevalence in hospitalized patients diagnosed with mental illnesses. Gen Hosp Psychiatry 2023; 84:250-252. [PMID: 37098446 PMCID: PMC10116153 DOI: 10.1016/j.genhosppsych.2023.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 04/08/2023] [Accepted: 04/18/2023] [Indexed: 04/27/2023]
Affiliation(s)
- Hiram Tendilla-Beltrán
- Laboratorio de Neuropsiquiatría, Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla (BUAP), Puebla, Mexico
| | | | | | | | | | - Gonzalo Flores
- Laboratorio de Neuropsiquiatría, Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla (BUAP), Puebla, Mexico.
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3
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Messina A, Concerto C, Rodolico A, Petralia A, Caraci F, Signorelli MS. Is It Time for a Paradigm Shift in the Treatment of Schizophrenia? The Use of Inflammation-Reducing and Neuroprotective Drugs-A Review. Brain Sci 2023; 13:957. [PMID: 37371435 DOI: 10.3390/brainsci13060957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 06/03/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023] Open
Abstract
Comprehending the pathogenesis of schizophrenia represents a challenge for global mental health. To date, although it is evident that alterations in dopaminergic, serotonergic, and glutamatergic neurotransmission underlie the clinical expressiveness of the disease, neuronal disconnections represent only an epiphenomenon. In recent years, several clinical studies have converged on the hypothesis of microglia hyperactivation and a consequent neuroinflammatory state as a pathogenic substrate of schizophrenia. Prenatal, perinatal, and postnatal factors can cause microglia to switch from M2 anti-inflammatory to M1 pro-inflammatory states. A continuous mild neuroinflammatory state progressively leads to neuronal loss, a reduction in dendritic spines, and myelin degeneration. The augmentation of drugs that reduce neuroinflammation to antipsychotics could be an effective therapeutic modality in managing schizophrenia. This review will consider studies in which drugs with anti-inflammatory and neuroprotective properties have been used in addition to antipsychotic treatment in patients with schizophrenia.
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Affiliation(s)
- Antonino Messina
- Department of Clinical and Experimental Medicine, Institute of Psychiatry, University of Catania, 95123 Catania, Italy
| | - Carmen Concerto
- Department of Clinical and Experimental Medicine, Institute of Psychiatry, University of Catania, 95123 Catania, Italy
| | - Alessandro Rodolico
- Department of Clinical and Experimental Medicine, Institute of Psychiatry, University of Catania, 95123 Catania, Italy
| | - Antonino Petralia
- Department of Clinical and Experimental Medicine, Institute of Psychiatry, University of Catania, 95123 Catania, Italy
| | - Filippo Caraci
- Department of Drug and Health Sciences, University of Catania, 95123 Catania, Italy
- Unit of Translational Neuropharmacology and Translational Neurosciences, Oasi Research Institute-IRCCS, 94018 Troina, Italy
| | - Maria Salvina Signorelli
- Department of Clinical and Experimental Medicine, Institute of Psychiatry, University of Catania, 95123 Catania, Italy
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4
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García-Dolores F, Tendilla-Beltrán H, Flores F, Carbajal-Rimoldi LA, Mendoza-Morales RC, Gómez-Mendoza LE, Vázquez-Hernández AJ, de la Cruz F, Genis-Mendoza AD, Nicolini H, Flores G. Increased suicide rates in Mexico City during the COVID-19 pandemic outbreak: An analysis spanning from 2016 to 2021. Heliyon 2023; 9:e16420. [PMID: 37274652 PMCID: PMC10228161 DOI: 10.1016/j.heliyon.2023.e16420] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 05/06/2023] [Accepted: 05/16/2023] [Indexed: 06/06/2023] Open
Abstract
Objective Coronavirus disease 2019 (COVID-19) has impacted mental health worldwide, and suicide can be a serious outcome of this. Thus, suicide characteristics were examined before and during the COVID-19 pandemic in Mexico City. Methods This is a retrospective study including all Mexico City residents who had a coroner's record with a cause of death of intentional self-harm (ICD-10) from January 2016 to December 2021. Results From 2016 to 2021, 3636 people committed suicide, of which 2869 were males (78.9%) and 767 females (21.1%). From 2016 to 2019 the suicide rate remained constant (∼6 per 100000) and dramatically increased in 2020 (10.45 per 100,000), to return to the levels of the previous year in 2021 (6.95 per 100000). The suicide rate in 2020 specifically increased from January to June (COVID-19 outbreak) in all age groups. Moreover, every year young people (15-24 years) have the maximum suicide rate and depression was the main suicide etiology. Conclusion The COVID-19 pandemic outbreak increased the suicide rate, regardless of age, but suicide prevalence was higher in males and young people, regardless of the COVID-19 pandemic. These findings confirm that suicide is a complex and multifactorial problem and will allow the establishment of new guidelines for prevention and care strategies.
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Affiliation(s)
- Fernando García-Dolores
- Instituto de Ciencias Forenses, Tribunal Superior de Justicia de la Ciudad de México (TSJCDMX), Mexico City, Mexico
| | - Hiram Tendilla-Beltrán
- Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla (BUAP), Puebla, Mexico
| | | | | | | | | | | | - Fidel de la Cruz
- Escuela Nacional de Ciencias Biológicas (ENCB), Instituto Politécnico Nacional (IPN), Mexico City, Mexico
| | - Alma Delia Genis-Mendoza
- Instituto Nacional de Medicina Genómica (INMEGEN), Mexico City, Mexico
- Hospital Psiquiátrico Infantil Dr. Juan N. Navarro, Mexico City, Mexico
| | - Humberto Nicolini
- Instituto Nacional de Medicina Genómica (INMEGEN), Mexico City, Mexico
| | - Gonzalo Flores
- Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla (BUAP), Puebla, Mexico
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5
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Liberman JN, Pesa J, Petrillo MP, Ruetsch C. Factors associated with COVID-19 Infection among a national population of individuals with schizophrenia or schizoaffective disorder in the United States. BMC Psychiatry 2022; 22:376. [PMID: 35655167 PMCID: PMC9161755 DOI: 10.1186/s12888-022-04026-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 05/30/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Individuals with schizophrenia are a vulnerable and under-served population who are also at risk for severe morbidity and mortality following COVID-19 infection. Our research was designed to identify factors that put individuals with schizophrenia at increased risk of COVID-19 infection. METHODS This study was a retrospective cohort analysis of medical and pharmacy claims among 493,796 individuals residing in the United States with schizophrenia or schizoaffective disorder, between January 1, 2019 and June 30, 2020. A confirmed diagnosis of COVID-19 infection by September 30, 2020 was regressed on demographics, social determinants, comorbidity, and pre-pandemic (December 2019 - February 2020) healthcare utilization characteristics. RESULTS A total of 35,249 (7.1%) individuals were diagnosed with COVID-19. Elevated odds of COVID-19 infection were associated with age, increasing consistently from 40-49 years (OR: 1.16) to 80+ years (OR:5.92), male sex (OR: 1.08), Medicaid (OR: 2.17) or Medicare (OR: 1.23) insurance, African American race (OR: 1.42), Hispanic ethnicity (OR: 1.23), and higher Charlson Comorbidity Index. Select psychiatric comorbidities (depressive disorder, adjustment disorder, bipolar disorder, anxiety, and sleep-wake disorder) were associated with elevated odds of infection, while alcohol use disorder and PTSD were associated with lower odds. A pre-pandemic psychiatry (OR:0.56) or community mental health center (OR:0.55) visit were associated with lower odds as was antipsychotic treatment with long-acting injectable antipsychotic (OR: 0.72) and oral antipsychotic (OR: 0.62). CONCLUSIONS Among individuals with schizophrenia, risk of COVID-19 infection was substantially higher among those with fewer economic resources, with greater medical and psychiatric comorbidity burden, and those who resided in African American or Hispanic communities. In contrast, individuals actively engaged in psychiatric treatment had substantially lower likelihood of infection. These results provide insights for healthcare providers that can translate into improved identification of at-risk individuals and interventions to reduce the risk and consequences of COVID-19 infection.
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Costanza A, Amerio A, Aguglia A, Serafini G, Amore M, Hasler R, Ambrosetti J, Bondolfi G, Sampogna G, Berardelli I, Fiorillo A, Pompili M, Nguyen KD. Hyper/neuroinflammation in COVID-19 and suicide etiopathogenesis: Hypothesis for a nefarious collision? Neurosci Biobehav Rev 2022; 136:104606. [PMID: 35289272 PMCID: PMC8916836 DOI: 10.1016/j.neubiorev.2022.104606] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 02/23/2022] [Accepted: 03/06/2022] [Indexed: 11/24/2022]
Abstract
Accumulating scientific and clinical evidence highlighted pathological hyperinflammation as a cardinal feature of SARS-CoV-2 infection and acute COVID-19 disease. With the emergence of long COVID-19 syndrome, several chronic health consequences, including neuropsychiatric sequelae, have gained attention from the public and medical communities. Since inflammatory mediators have also been accredited as putative biomarkers of suicidal ideations and behaviors, hyper- and neuroinflammation might share some colliding points, overlapping and being interconnected in the context of COVID-19. This review aims to provide a summary of current knowledge on the molecular and cellular mechanisms of COVID-19-associated hyper/neuroinflammation with focus on their relevance to the inflammatory hypothesis of suicide development. Subsequently, strategies to alleviate COVID-19 hyper/neuroinflammation by immunomodulatory agents (many of which at experimental stages) as well as psychopharmacologic/psychotherapeutic approaches are also mentioned. While suicide risk in COVID-19 survivors - until now little known - needs further analysis through longitudinal studies, current observations and mechanistic postulates warrant additional attention to this possibly emerging mental health concern.
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Affiliation(s)
- A Costanza
- Departement of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland; Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland.
| | - A Amerio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - A Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - G Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - M Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - R Hasler
- Departement of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland; Department of Psychiatry, Service of Psychiatric Specialties, University Hospitals of Geneva (HUG), Geneva, Switzerland
| | - J Ambrosetti
- Department of Psychiatry and Department of Emergency, Emergency Psychiatric Unit (UAUP), Geneva University Hospitals (HUG), Geneva, Switzerland
| | - G Bondolfi
- Departement of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland; Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland; Department of Psychiatry, Service of Liaison Psychiatry and Crisis Intervention (SPLIC), University Hospitals (HUG), Geneva, Switzerland
| | - G Sampogna
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - I Berardelli
- Sant'Andrea Hospital, "Sapienza" University of Rome, Rome, Italy
| | - A Fiorillo
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - M Pompili
- Sant'Andrea Hospital, "Sapienza" University of Rome, Rome, Italy
| | - K D Nguyen
- Tranquis Therapeutics, Palo Alto, CA, USA; Department of Microbiology and Immunology, Stanford University, Palo Alto, CA, USA
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Prokopez CR, Farinola R, Vallejos M, Lopredo LS, Sfriso LE, Chiapella LC, Arce C, Corral RM, Cuesta MJ, Alomo M. Olanzapine, risperidone and quetiapine: Do these atypical antipsychotics have a protective effect for SARS-CoV-2? Schizophr Res 2022; 241:140-141. [PMID: 35123336 PMCID: PMC8784573 DOI: 10.1016/j.schres.2022.01.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 01/16/2022] [Accepted: 01/16/2022] [Indexed: 01/13/2023]
Affiliation(s)
- Cintia R. Prokopez
- Braulio Aurelio Moyano Neuropsychiatric Hospital, Buenos Aires, Argentina,Institute of Pharmacology, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina,Corresponding author at: Paraguay 2155, Buenos Aires City, Argentina
| | | | | | - Lorena S. Lopredo
- Braulio Aurelio Moyano Neuropsychiatric Hospital, Buenos Aires, Argentina
| | - Luciano E. Sfriso
- Braulio Aurelio Moyano Neuropsychiatric Hospital, Buenos Aires, Argentina
| | - Luciana C. Chiapella
- National Scientific and Technical Research Council (Gordon, Jang et al.), Buenos Aires, Argentina,Pharmacology Area, Faculty of Biochemical and Pharmaceutical Sciences, National University of Rosario, Santa Fe, Argentina
| | - Claudio Arce
- Braulio Aurelio Moyano Neuropsychiatric Hospital, Buenos Aires, Argentina
| | | | - Manuel J. Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain,IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Martín Alomo
- Braulio Aurelio Moyano Neuropsychiatric Hospital, Buenos Aires, Argentina,Faculty of Psychology, University of Buenos Aires, Buenos Aires, Argentina
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Rivas‐Ramírez ÁR, Tendilla‐Beltrán H, Gómez‐Mendoza LE, Loaiza G, Flores G. Patients with schizophrenia have decreased COVID-19 prevalence among hospitalised patients with psychiatric and neurological diseases: A retrospective analysis in Mexican population. Int J Clin Pract 2021; 75:e14528. [PMID: 34125988 PMCID: PMC8420595 DOI: 10.1111/ijcp.14528] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 06/13/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Increased coronavirus disease 2019 (COVID-19) incidence and mortality in hospitalised patients with psychiatric and neurologic disorders have been reported. METHODS The clinical records of 198 patients with psychiatric and neurological disorders hospitalised in the Dr Rafael Serrano Psychiatric Hospital in Puebla during the peak of the first wave of the COVID-19 pandemic in Mexico were analysed for psychiatric or neurologic diagnosis, gender, age, medical diagnosis, and COVID-19 prevalence. For patients with COVID-19, the effects of gender, and medical diagnosis were explored. RESULTS There was an increased COVID-19 prevalence in the studied population (43.94%), compared with the national Mexican (~0.21% to 0.63%) and worldwide average in the general population (~0.13% to 4.28%). However, the mortality rate (5.75%) was lower than that reported in Mexico (11.28%-13.55%), which was higher than the worldwide average (2.95%-4.98%). We detected increased COVID-19 prevalence in patients with comorbidities (odds ratios [OR] 0.4; 95% CI: 0.2-1, P = .0447). Moreover, patients with schizophrenia spectrum disorders have a decreased predisposition to COVID-19 (OR 0.4, 95% CI: 0.2-0.8; P = .0250), as opposed to patients with intellectual disability that are predisposed to COVID-19 (OR 2.2, 95% CI: 0.2-0.8; P = .0434), in comparison with the rest of the hospital population. CONCLUSION The prevalence of COVID-19 in hospitalised patients with psychiatric disorders is increased compared with that of the general population; however, a lower mortality rate was detected. Also, an increased risk of COVID-19 was detected in patients with comorbidities. Interestingly, the observed variation in COVID-19 prevalence in patients with schizophrenia and intellectual disability was not associated with age or other specific medical diagnoses.
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Affiliation(s)
| | - Hiram Tendilla‐Beltrán
- Laboratorio de NeuropsiquiatríaInstituto de FisiologíaBenemérita Universidad Autónoma de Puebla (BUAP)PueblaMexico
| | | | | | - Gonzalo Flores
- Laboratorio de NeuropsiquiatríaInstituto de FisiologíaBenemérita Universidad Autónoma de Puebla (BUAP)PueblaMexico
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