Risk factors of COVID-19 in subjects with and without mental disorders

Detecting mental and physical disorders using multi-task learning equipped with knowledge graph attention network

Mental and physical disorders (MPD) are inextricably linked in many medical cases; psychosomatic diseases can be induced by mental concerns and psychological discomfort can ensue from physiological diseases. However, existing medical informatics studies focus on identifying mental or physical disorders from a unilateral perspective. Consequently, no existing domain knowledge base, corpus, or detection modeling approach considers mental as well as physical aspects concurrently. This paper proposes a joint modeling approach to detect MPD. First, we crawl through online medical consultation records of patients from websites and build an MPD knowledge ontology by extracting the core conceptual features of the text. Based on the ontology, an MPD knowledge graph containing 12,673 nodes and 82,195 relations is obtained using term matching with a domain thesaurus of each concept. Subsequently, an MPD corpus with fine-grained severities (None, Mild, Moderate, Severe, Dangerous) and 8909 records is constructed by formulating MPD classification criteria and a data annotation process under the guidance of domain experts. Taking the knowledge graph and corpus as the dataset, we design a multi-task learning model to detect the MPD severity, in which a knowledge graph attention network (KGAT) is embedded to better extract knowledge features. Experiments are performed to demonstrate the effectiveness of our model. Furthermore, we employ ontology-based and centrality-based methods to discover additional potential inferred knowledge, which can be captured by KGAT so as to improve the prediction performance and interpretability of our model. Our dataset has been made publicly available, so it can be further used as a medical informatics reference in the fields of psychosomatic medicine, psychiatrics, physical co-morbidity, and so on.

COVID-19 risk, course and outcome in people with mental disorders: a systematic review and meta-analyses

AIMS

It has been suggested that people with mental disorders have an elevated risk to acquire severe acute respiratory syndrome coronavirus 2 and to be disproportionally affected by coronavirus disease 19 (COVID-19) once infected. We aimed to analyse the COVID-19 infection rate, course and outcome, including mortality and long COVID, in people with anxiety, depressive, neurodevelopmental, schizophrenia spectrum and substance use disorders relative to control subjects without these disorders.

METHODS

This study constitutes a preregistered systematic review and random-effects frequentist and Bayesian meta-analyses. Major databases were searched up until 27 June 2023.

RESULTS

Eighty-one original articles were included reporting 304 cross-sectional and prospective effect size estimates (median n per effect-size = 114837) regarding associations of interest. Infection risk was not significantly increased for any mental disorder that we investigated relative to samples of people without these disorders. The course of COVID-19, however, is relatively severe, and long COVID and COVID-19-related hospitalization are more likely in all patient samples that we investigated. The odds of dying from COVID-19 were high in people with most types of mental disorders, except for those with anxiety and neurodevelopmental disorders relative to non-patient samples (pooled ORs range, 1.26-2.57). Bayesian analyses confirmed the findings from the frequentist approach and complemented them with estimates of the strength of evidence.

CONCLUSIONS

Once infected, people with pre-existing mental disorders are at an elevated risk for a severe COVID-19 course and outcome, including long COVID and mortality, relative to people without pre-existing mental disorders, despite an infection risk not significantly increased.

COVID-19 and alcohol consumption: recommendations in the Omicron era

In the early stages of the pandemic, the first reports began that alcohol consumption could increase the risk of becoming infected and worsening the prognosis disease. This is for two reasons: behavioral and socio-economic factors that characterize a part of this population can be the cause of viral spread and a direct or indirect negative action of ethanol on the immune system. The data used for the preparation of these recommendations are based on a detailed analysis of the scientific literature published before March 31, 2022 (Web of Science, Scopus, Google Scholar). Furthermore, in the process of developing this work, we consulted the guidelines/position papers of the Italian Society on Alcohol and of the World Health Organization. It has been confirmed that AC is in COVID-19 era a risky behavior and that AUD and substance use disorder (SUD) patients are certainly at greater risk of contracting infection and also of having a worse course. In light of what has been said, some recommendations can be made: correctly inform the general population that AC negatively interacts with COVID-19 infection; reducing the COVID-19 risk by advocating healthy lifestyle habits (smoke, diet, physical exercise, etc.) and preferential policies in population with comorbidities; implement actions that reduce the average consumption of alcohol by avoiding hazardous/harmful consumption. Abstention is better; identify alcohol consumption through a more in-depth alcohol history, using the AUDIT; AUDs patients are frail patients deserving a complete vaccination course; suggest a period of alcoholic abstention of at least thirty days before vaccination to be maintained for the following fifteen days; promoting health education campaigns for young people in order to promote vaccination culture and correct lifestyles.

Factors associated with mental health outcomes after COVID-19: A 24-month follow-up longitudinal study

OBJECTIVE

Investigate the proportion of mental health outcomes (MHOs) and associated factors in COVID-19 survivors during a 24-month follow-up period.

METHOD

An observational, prospective study was performed in a teaching hospital in Barranquilla, Colombia, from April 1, 2020, to August 30, 2022. A cohort of 1565 COVID-19 survivors was recruited after discharge from the emergency room (ER), inpatient floor (IF), and intensive care unit (ICU) services and followed for 24 -months. The clinical assessment included screening scales for symptoms of anxiety, depressive, post-traumatic stress disorder (PTSD), and insomnia. Sociodemographic and clinical factors were also collected to identify possible associated factors. Descriptive, bivariate and mixed random-effect linear models were performed.

RESULTS

A total of 1565 patients were included, of whom 785 (50.35%) were men. A large proportion of patients with mental symptoms were identified. After 24-months, the proportions of anxiety, depression, PTSD, and insomnia symptoms remained high at 16.55%, 21.79%, 35.27%, and 23.86%, respectively. Social factors, location of hospital stays, physical comorbidities, and the severity of COVID-19 were significantly associated with anxiety, depression, PTSD, and insomnia symptoms.

CONCLUSIONS

COVID-19's 2-year deleterious impacts on mental health, as well as the variables influencing these findings, have been documented. These results should aid in the development of public health initiatives to reduce morbidity rates in post-COVID-19 patients.

Risk factors for SARS-CoV-2 infection during the early stages of the COVID-19 pandemic: a systematic literature review

Introduction

Identifying SARS-CoV-2 infection risk factors allows targeted public health and social measures (PHSM). As new, more transmissible variants of concern (VoC) emerge, vaccination rates increase and PHSM are eased, it is important to understand any potential change to infection risk factors. The aim of this systematic literature review is to describe the risk factors for SARS-CoV-2 infection by VoC.

Methods

A literature search was performed in MEDLINE, PubMed and Embase databases on 5 May 2022. Eligibility included: observational studies published in English after 1 January 2020; any age group; the outcome of SARS-CoV-2 infection; and any potential risk factors investigated in the study. Results were synthesized into a narrative summary with respect to measures of association, by VoC. ROBINS-E tool was utilized for risk of bias assessment.

Results

Of 6,197 studies retrieved, 43 studies were included after screening. Common risk factors included older age, minority ethnic group, low socioeconomic status, male gender, increased household size, occupation/lower income level, inability to work from home, public transport use, and lower education level. Most studies were undertaken when the ancestral strain was predominant. Many studies had some selection bias due to testing criteria and limited laboratory capacity.

Conclusion

Understanding who is at risk enables the development of strategies that target priority groups at each of the different stages of a pandemic and helps inform vaccination strategies and other interventions which may also inform public health responses to future respiratory infection outbreaks. While it was not possible to determine changes to infection risk by recent VoC in this review, the risk factors identified will add to the overall understanding of the groups who are at greatest risk of infection in the early stages of a respiratory virus outbreak.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022330706, PROSPERO [CRD42022330706].

The impact of preexisting psychiatric disorders and antidepressant use on COVID-19 related outcomes: a multicenter study

Pre-existing mental disorders are linked to COVID-19-related outcomes. However, the findings are inconsistent and a thorough analysis of a broader spectrum of outcomes such as COVID-19 infection severity, morbidity, and mortality is required. We investigated whether the presence of psychiatric diagnoses and/or the use of antidepressants influenced the severity of the outcome of COVID-19. This retrospective cohort study evaluated electronic health records from the INSIGHT Clinical Research Network in 116,498 individuals who were diagnosed with COVID-19 between March 1, 2020, and February 23, 2021. We examined hospitalization, intubation/mechanical ventilation, acute kidney failure, severe sepsis, and death as COVID-19-related outcomes. After using propensity score matching to control for demographics and medical comorbidities, we used contingency tables to assess whether patients with (1) a history of psychiatric disorders were at higher risk of more severe COVID-19-related outcomes and (2) if use of antidepressants decreased the risk of more severe COVID-19 infection. Pre-existing psychiatric disorders were associated with an increased risk for hospitalization, and subsequent outcomes such as acute kidney failure and severe sepsis, including an increased risk of death in patients with schizophrenia spectrum disorders or bipolar disorders. The use of antidepressants was associated with significantly reduced risk of sepsis (p = 0.033), death (p = 0.026). Psychiatric disorder diagnosis prior to a COVID-19-related healthcare encounter increased the risk of more severe COVID-19-related outcomes as well as subsequent health complications. However, there are indications that the use of antidepressants might decrease this risk. This may have significant implications for the treatment and prognosis of patients with COVID-19.

The Up-Side of the COVID-19 Pandemic: Are Core Belief Violation and Meaning Making Associated with Post-Traumatic Growth?

The negative impact of the COVID-19 pandemic on mental health has been extensively documented, while its possible positive impact on the individual, defined as Post-Traumatic Growth (PTG), has been much less investigated. The present study examines the association between PTG and socio-demographic aspects, pre-pandemic psychological adjustment, stressors directly linked to COVID-19 and four psychological factors theoretically implicated in the change processes (core belief violation, meaning-making, vulnerability and mortality perception). During the second wave of the pandemic 680 medical patients completed an online survey on direct and indirect COVID-19 stressors, health and demographic information, post-traumatic growth, core belief violation, meaning-making capacity, feelings of vulnerability and perceptions of personal mortality. Violation of core beliefs, feelings of vulnerability and mortality, and pre-pandemic mental illness positively correlated with post-traumatic growth. Moreover, the diagnosis of COVID-19, stronger violation of core beliefs, greater meaning-making ability, and lower pre-existing mental illness predicted greater PTG. Finally, a moderating effect of meaning-making ability was found. The clinical implications were discussed.

A longitudinal study on college students' depressive symptoms during the COVID-19 pandemic: The trajectories, antecedents, and outcomes

The ongoing COVID-19 pandemic is not only an immediate hazard but also a long-term risk to the development of depressive symptoms. However, it remains unclear how people's depressive symptoms change with the process of COVID-19. Further, there is also a paucity of research on the underlying antecedents and outcomes of depressive symptoms during this global health crisis. In this study, a longitudinal study was conducted in China and the data of 559 participants were collected from the outbreak period to the normalization period of the pandemic through self-report questionnaires. Depressive symptoms were longitudinally analyzed using Patient Health Questionnaire-9. Core variables involving society, family, individual cognition, and behaviors were studied as determinants or consequences. Latent growth curve model analyses indicated that college students had mild depressive symptoms at the initial stage of COVID-19 with a subsequent decreasing linear slope. Depressive symptoms were significantly predicted by college students' risk perception of COVID-19, social support, family functioning, and smartphone addiction tendency. Further, their depressive symptoms predicted the changes in smartphone addiction tendency and levels of hope. In conclusion, current findings can provide implications for future prevention and intervention of mental disorders to assist college students through such challenging times.

The Relationship between Mental Disorders and the COVID-19 Pandemic—Course, Risk Factors, and Potential Consequences

In this review the authors discuss that COVID-19 has already had a direct impact on the physical health of many people and that it appears to have put at risk the mental health of large populations. In this review, we also discuss the relationship between mental disorders and the SARS-CoV-2 infection. We convey the disorders’ risk factors and the more serious mental disorder consequences of COVID-19. People with mental health disorders could be more susceptible to the emotional responses brought on by the COVID-19 epidemic. The COVID-19 pandemic may adversely influence the mental health of patients with already diagnosed mental disorders. For the aim of dealing better with the psychological problems of people afflicted by the COVID-19 pandemic, new psychological procedures are required.

Comparisons of Clinical Features and Outcomes of COVID-19 between Patients with Pediatric Onset Inflammatory Rheumatic Diseases and Healthy Children

(1) Background: We aimed to describe the clinical features and outcomes of coronavirus disease-2019 (COVID-19) in children and late adolescents with inflammatory rheumatic diseases (IRD) and to measure their severity risks by comparing them with healthy children. (2) Methods: Among children and late adolescents found to be severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) positive via polymerase chain reaction (PCR) test, IRD patients with an at least six-months follow-up duration, and healthy children were included in the study. Data were obtained retrospectively. (3) Results: A total of 658 (339 (51.5%) females) (healthy children: 506, IRD patients: 152) subjects were included in the study. While 570 of 658 (86.6%) experienced COVID-19-related symptoms, only 21 (3.19%) required hospitalization with a median duration of 5 (1–30) days. Fever, dry cough, and fatigue were the most common symptoms. None of evaluated subjects died, and all recovered without any significant sequelae. The presence of any IRD was found to increase the risk of both hospitalization (OR: 5.205; 95% CI: 2.003–13.524) and symptomatic infection (OR: 2.579; 95% CI: 1.068–6.228). Furthermore, increasing age was significantly associated with symptomatic infection (OR: 1.051; 95% CI: 1.009–1.095). (4) Conclusions: Our study emphasizes that pediatric rheumatologists should monitor their patients closely for relatively poor COVID-19 outcomes.

Joint European policy on the COVID-19 risks for people with mental disorders: An umbrella review and evidence- and consensus-based recommendations for mental and public health

As COVID-19 becomes endemic, identifying vulnerable population groups for severe infection outcomes and defining rapid and effective preventive and therapeutic strategies remains a public health priority. We performed an umbrella review, including comprehensive studies (meta-analyses and systematic reviews) investigating COVID-19 risk for infection, hospitalization, intensive care unit (ICU) admission, and mortality in people with psychiatric disorders, and outlined evidence- and consensus-based recommendations for overcoming potential barriers that psychiatric patients may experience in preventing and managing COVID-19, and defining optimal therapeutic options and current research priorities in psychiatry. We searched Web of Science, PubMed, and Ovid/PsycINFO databases up to 17 January 2022 for the umbrella review. We synthesized evidence, extracting when available pooled odd ratio estimates for the categories “any mental disorder” and “severe mental disorders.” The quality of each study was assessed using the AMSTAR-2 approach and ranking evidence quality. We identified four systematic review/meta-analysis combinations, one meta-analysis, and three systematic reviews, each including up to 28 original studies. Although we rated the quality of studies from moderate to low and the evidence ranged from highly suggestive to non-significant, we found consistent evidence that people with mental illness are at increased risk of COVID-19 infection, hospitalization, and most importantly mortality, but not of ICU admission. The risk and the burden of COVID-19 in people with mental disorders, in particular those with severe mental illness, can no longer be ignored but demands urgent targeted and persistent action. Twenty-two recommendations are proposed to facilitate this process.

Risk of inflammatory bowel disease appears to vary across different frequency, amount, and subtype of alcoholic beverages

Objective

Inflammatory bowel disease (IBD) and alcohol use has become a significant and growing public health concern. Alcohol use has been reported to be the most-avoided diet item among IBD patients. However, knowledge regarding the impact of different classes of alcoholic beverages on the management of IBD is limited. Our study aims to evaluate the association of different frequencies, amounts, and subtypes of alcoholic beverages with IBD risk.

Methods

The UK Biobank comprised 7,095 subjects with IBD and 4,95,410 subjects without IBD. Multivariate Logistic regression, stratifying analysis, and interaction terms were used to estimate the odds ratios (ORs) and 95% confidence intervals (95% CIs) of IBD. A generalized additive model was used to evaluate the linearity associations of the total amount of all alcoholic beverages or that of each of five alcoholic beverages with IBD risk.

Results

Compared with non-drinkers, the IBD risk was 12 to 16% lower in red wine consumers (1-2 glasses/week, OR [95%CI], 0.88 [0.80, 0.97]; 3-4 glasses/week, 0.84 [0.76, 0.93]; ≥5 glasses/week, 0.86 [0.78, 0.95]), whereas 12% higher in white wine and champagne consumers (1-2 glasses/week, 1.12 [1.03, 1.22]). Stratifying analysis showed low-frequency red wine consumers were associated with a lower IBD risk (0.85 [0.74, 0.97]), whereas spirits consumers were associated with a higher risk (1.28 [1.03, 1.59]). High doge of red wine consumers were associated with a lower IBD risk (above guidelines, 0.80 [0.67, 0.97]; double above, 0.83 [0.71, 0.97]), whereas high doge white wine and champagne (1.32 [1.09, 1.61]) and beer and cider (1.26 [1.02, 1.54]) consumers were associated with a higher IBD risk. White wine and champagne showed a significant interaction effect with high doge alcohol consumption (1.27 [1.03-1.58], p = 0.029). The dose-response association showed an increased IBD risk with more number of alcohol consumption of white wine and champagne, beer and cider, or the total amount of all alcoholic beverages. However, red wine is at low risk across the whole dose cycle.

Conclusions

The IBD risk appears to vary across different frequencies, amounts, and subtypes of alcoholic beverages. Overall, alcohol intake is not recommended.

Intellectual disability and COVID-19: A bibliometric review

BACKGROUND

During the COVID-19 pandemic, the vulnerabilities of certain groups of people have been highlighted, such as people with intellectual disability (ID). Although related research on ID has developed rapidly during the COVID-19 pandemic, the quantitative analysis of those research results has not been systematically performed through bibliometric analysis. Bibliometric analysis is a useful and rigorous method to explore large volumes of research data, and it allows researchers to extract quantitative information on distribution by author, time, country, and journal.

AIM

The aim of the present study is to comprehensively analyze the current status and developing trends in publications on ID research related to and conducted during the COVID-19 pandemic.

METHODS

A bibliometric analysis was performed using the Web of Science database. Biblioshiny software was used to analyze and visualize the following information: main information of dataset, annual scientific production, journals which published the most relevant sources, most-cited authors, most-cited countries, most-cited global documents, word-cloud of keywords authors have used, and both the co-occurrence and co-citation networks.

RESULTS

A total of 450 publications were included. The average number of citations per document was 5.104. Among the top three journals, Journal of Applied Research in Intellectual Disabilities published 32 articles, Journal of Intellectual Disability Research published 29 articles, and British Journal of Learning Disabilities published 17 articles. The article with the title COVID-19 and People with Intellectual Disability: Impact of a Pandemic was the most cited with total 144 citations The United Kingdom had the most publications and had strong cooperative relationships with the United States, Canada, and Australia. The most popular keywords included mental health, autism, developmental disability, and lockdown. Thematic map analysis identified several possible clusters, including telemedicine, physical activities, and mental health.

CONCLUSION

The present study provides a better understanding in this research field and may help clinicians, researchers and stakeholders to obtain more comprehensive view of ID and COVID-19. The insights gained from this analysis could inform future research.