Objectives Older adults are particularly vulnerable to the negative consequences of antipsychotic exposure and are disproportionally affected by higher mortality from coronavirus disease 2019 (COVID-19). Our goal was to determine whether concurrent antipsychotic medication use was associated with increased COVID-19 mortality in older patients with preexisting behavioral health problems. We also report on findings from post-COVID follow-ups. Design Retrospective observational study. Participants Outpatients at a geriatric psychiatric clinic in New York City. Measurements Demographic and clinical data including medication, diagnosis and Clinical Global Impression Severity (CGI-S) scales on outpatients who had COVID-19 between February 28 th and October 1 st 2020 were extracted from the electronic health records (EHR) from the hospital. Results A total of 56 patients were diagnosed with COVID-19 (mean age 76 years; median age 75 years) and 13 (23.2%) died. We found an increased mortality risk for patients who were prescribed at least one antipsychotic medication at the time of COVID-19 infection (Fisher’s exact test P = 0.009, OR = 11.1, 95% confidence interval: 1.4–96.0). This result remains significant after adjusting for age, gender, housing context and dementia (Logistic regression P = 0.035, Beta = 2.4). Furthermore, we found that most patients who survived COVID-19 (88.4%) recovered to pre-COVID baseline in terms of psychiatric symptoms. Comparison of pre- and post-COVID assessments of CGI-S for 33 patients who recovered from COVID-19 were not significantly different. Conclusion We observed a higher COVID-19 mortality associated with concurrent antipsychotics use in older patients receiving behavioral health services. The majority of patients in our geriatric clinic who recovered from COVID-19 appeared to return to their pre-COVID psychiatric function. More precise estimates of the risk associated with antipsychotic treatment in older patients with COVID-19 and other underlying factors will come from larger datasets and meta-analyses.
【초록키워드】 COVID-19, Treatment, coronavirus disease, Mortality, hospital, Diagnosis, Gender, risk, Symptoms, New York City, Electronic health record, Dementia, older patient, Health, COVID-19 infection, clinical, Health services, Patient, Beta, age, dataset, estimate, assessment, medication, demographic, Outpatient, meta-analyses, COVID-19 mortality, older adult, EHR, Psychiatric, Factor, problems, Clinical data, median age, participant, increased mortality, Fisher’s exact test, impression, measurement, objective, consequence, Result, affected, died, receiving, majority, determine, baseline, diagnosed with COVID-19, not significantly different, patients who survived, with COVID-19, 【제목키워드】 Clinical outcome, psychiatry, medication, association, Outpatient, with COVID-19,