Correlates of poor clinical outcomes related to COVID-19 among older people with psychiatric illness - a mixed methods study
Surajudeen Abdulrahman, Naser Al-Balushi, Jason Holdcroft-Long, Uzma Khan, Bipin Ravindran, Sujata Das, Anto P Rajkumar
The International Journal of Psychiatry in Medicine, doi:10.1177/00912174231171220
Objective: COVID-19 leads to highly variable clinical outcomes among older people with psychiatric and medical co-morbidities. Evidence guiding management of future outbreaks among this vulnerable population in in-patient psychiatry settings are sparse. Hence, we aimed to investigate the correlates of poor clinical outcomes related to COVID-19 and to explore the perspectives of COVID-19 survivors in in-patient psychiatry settings. Method: We investigated the correlates of poor clinical outcomes related to COVID-19 using retrospective chart review of 81 older people in in-patient psychiatry settings. Correlates of clinical outcomes related to COVID-19 were assessed by multiple logistic regression models. Moreover, we explored the perspectives of 10 of
Author contributions We confirm that all authors met the four ICMJE criteria for authorship. SD, BR and APR conceived this study, and APR wrote the study protocol. JHL, UK, SD, BR, and APR completed the retrospective chart review. SA completed the in-depth interviews. SA and APR transcribed the in-depth interviews. NA and APR analysed the retrospective chart review data. SA analysed the qualitative data. SA and NA wrote the initial manuscript. APR provided necessary supervision for SA and NA. All authors were involved in critical revisions of the manuscript and all authors have approved the final submitted version.
Declaration of conflicting interests The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Ethical approval This research has obtained ethics approval from the London South-East Research Ethics Committee (20/LO/1282/133124/2020).
Informed consent Written informed consent was obtained from all participants before the in-depth interviews.
ORCID iDs Anto P Rajkumar https://orcid.org/0000-0003-3203-6326 Surajudeen Abdulrahman https://orcid.org/0000-0003-4445-1295
Supplemental Material Supplemental material for this article is available online.
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'abstract': '<jats:sec><jats:title>Objective</jats:title><jats:p> COVID-19 leads to highly variable '
'clinical outcomes among older people with psychiatric and medical co-morbidities. Evidence '
'guiding management of future outbreaks among this vulnerable population in in-patient '
'psychiatry settings are sparse. Hence, we aimed to investigate the correlates of poor '
'clinical outcomes related to COVID-19 and to explore the perspectives of COVID-19 survivors '
'in in-patient psychiatry settings. '
'</jats:p></jats:sec><jats:sec><jats:title>Method</jats:title><jats:p> We investigated the '
'correlates of poor clinical outcomes related to COVID-19 using retrospective chart review of '
'81 older people in in-patient psychiatry settings. Correlates of clinical outcomes related to '
'COVID-19 were assessed by multiple logistic regression models. Moreover, we explored the '
'perspectives of 10 of those COVID-19 survivors by qualitative interviews. We analysed the '
'qualitative data using thematic analysis. '
'</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> Although 25.9% (n = '
'21) participants were asymptomatic, there was high COVID-19 related mortality rate (14.8%; n '
'= 12). Vitamin-D deficiency, anticholinergic burden, and isolation policies within '
'psychiatric wards were significantly ( P < 0.05) associated with COVID-19 related deaths. '
'Participants emphasised the importance of strengthening local support networks and making '
'vaccination centres more accessible. '
'</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p> Reducing '
'anticholinergic prescriptions and improving isolation policies may mitigate poor clinical '
'outcomes. Future research investigating the impact of vitamin-D supplementation on COVID-19 '
'related outcomes are warranted. </jats:p></jats:sec>',
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