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Death Associated With Coronavirus (COVID-19) Infection in Individuals With Severe Mental Disorders in Sweden During the Early Months of the Outbreak: An Exploratory Cross-Sectional Analysis of a Population-Based Register Study
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.ORCID iD: 0000-0001-7868-8894
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry. Department of Clinical Neuroscience, Center for Psychiatry Research & Stockholm Health Care Services, Stockholm County Council, Karolinska Institutet, Stockholm, Sweden.
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.ORCID iD: 0000-0001-8271-5058
Umeå University, Faculty of Medicine, Department of Clinical Microbiology.
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2021 (English)In: Frontiers in Psychiatry, E-ISSN 1664-0640, Vol. 11, article id 609579Article in journal (Refereed) Published
Abstract [en]

Background: Individuals with severe mental disorder (SMD) have a higher risk of somatic comorbidity and mortality than the rest of the population. We set up a population-based study to assess whether individuals with SMD had a higher risk of death associated with a COVID-19 infection (COVID-19 associated death) than individuals without SMD.

Methods: Exploratory analysis with a cross-sectional design in the framework of a population-based register study covering the entire Swedish population. The Swedish Board for Health and Welfare (Socialstyrelsen) provided anonymized tabulated summary data for further analysis. We compared numbers of COVID-19 associated death in individuals with SMD (cases) and without SMD (controls). We calculated the odds ratio (OR) for the whole sample and by age group and four comorbidities, namely diabetes, cardiovascular disease, hypertension, chronic lung disease.

Results: The sample comprised of 7,923,859 individuals, 103,999 with SMD and 7,819,860 controls. There were 130 (0.1%) COVID-19 associated deaths in the SMD group and 4,945 (0.06%) in the control group, corresponding to an OR of 1.98 (CI 1.66-2.35; p < 0.001). The odds were 4-fold for the age groups between 60 and 79 years and 1.5-fold for cardiovascular diseases. Individuals with SMD without any of the risk factors under study had 3-fold odds of COVID-19 associated death.

Conclusion: Our preliminary results identify individuals with SMD as a further group at increased risk of COVID-19 associated death. In regard to comorbidities, future studies should explore the potential confounding or mediation role in the relationship between SMD and COVID-19 associated deaths.

Place, publisher, year, edition, pages
Frontiers Media S.A., 2021. Vol. 11, article id 609579
Keywords [en]
coronavirus, COVID-19, severe mental disorder, death, risk factors, mortality, psychotic disorder, bipolar disorder
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-180161DOI: 10.3389/fpsyt.2020.609579ISI: 000610876800001PubMedID: 33488430Scopus ID: 2-s2.0-85099733688OAI: oai:DiVA.org:umu-180161DiVA, id: diva2:1530187
Available from: 2021-02-22 Created: 2021-02-22 Last updated: 2024-01-17Bibliographically approved

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Maripuu, MartinBendix, MarieÖhlund, LouiseWiderström, MicaelWerneke, Ursula

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