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.
References
Ashique, Gupta, Gupta, Vitamin D-A prominent immunomodulator to prevent COVID-19 infection, Int J Rheum Dis,
doi:10.1111/1756-185X.14477Bassatne, Basbous, Chakhtoura, El Zein, Fuleihan, The link between COVID-19 and vitamin D (VIVID): A systematic review and meta-analysis, Metabolism,
doi:10.1016/j.metabol.2021.154753Bishara, Scott, Stewart, Safe prescribing in cognitively vulnerable patients: The use of the anticholinergic effect on cognition (AEC) tool in older adult mental health services, BJPsych Bull,
doi:10.1192/bjb.2019.43Booth, Reed, Ponzo, Population risk factors for severe disease and mortality in COVID-19: A global systematic review and meta-analysis, PLoS One,
doi:10.1371/journal.pone.0247461Chatterjee, Carnahan, Chen, Holmes, Aparasu, Anticholinergic medication use and risk of pneumonia in elderly adults: A nested case-control study, J Am Geriatr Soc,
doi:10.1111/jgs.13932Docherty, Harrison, Green, Features of 20 133 UK patients in hospital with covid-19 using the ISARIC WHO clinical characterisation protocol: Prospective observational cohort study, BMJ,
doi:10.1136/bmj.m1985Fond, Pauly, Leone, Disparities in intensive care unit admission and mortality among patients with schizophrenia and COVID-19: A national cohort study, Schizophr Bull,
doi:10.1093/schbul/sbaa158Ghasemi, Darvishi, Salari, Hosseinian-Far, Akbari et al., Global prevalence of polypharmacy among the COVID-19 patients: A comprehensive systematic review and meta-analysis of observational studies, Trop Med Health,
doi:10.1186/s41182-022-00456-xJick, Mixing qualitative and quantitative methods: Triangulation in action, Adm Sci Q
Kiyumi, Kalra, Davies, Kalhan, The impact of Vitamin D deficiency on the severity of symptoms and mortality rate among adult patients with Covid-19: A systematic review and meta-analysis, Indian J Endocrinol Metab,
doi:10.4103/ijem.ijem_115_21Kummel, Krumbein, Fragkou, Vitamin D supplementation for the treatment of COVID-19: A systematic review and meta-analysis of randomized controlled trials, Front Immunol,
doi:10.3389/fimmu.2022.1023903Li, Huang, Zou, Epidemiology of COVID-19: A systematic review and metaanalysis of clinical characteristics, risk factors, and outcomes, J Med Virol,
doi:10.1002/jmv.26424Li, Li, Fortunati, Krystal, Association of a prior psychiatric diagnosis with mortality among hospitalized patients with coronavirus disease 2019 (COVID-19) infection, JAMA Netw Open,
doi:10.1001/jamanetworkopen.2020.23282Li, Liu, Jing, Mortality risk of COVID-19 in elderly males with comorbidities: A multi-country study, Aging,
doi:10.18632/aging.202456Li, Wang, Liu, Huang, Shi, Epidemiological characteristics of confirmed COVID-19 in Guizhou province, China, Disaster Med Public Health Prep,
doi:10.1017/dmp.2020.134Liu, Chen, Han, Clinical features of COVID-19 in elderly patients: A comparison with young and middle-aged patients, J Infect,
doi:10.1016/j.jinf.2020.03.005Liu, Sun, Wang, Zhang, Zhao et al., Low vitamin D status is associated with coronavirus disease 2019 outcomes: A systematic review and meta-analysis, Int J Infect Dis,
doi:10.1016/j.ijid.2020.12.077Lowry, Woodman, Soiza, Mangoni, Associations between the anticholinergic risk scale score and physical function: Potential implications for adverse outcomes in older hospitalized patients, J Am Med Dir Assoc,
doi:10.1016/j.jamda.2011.03.006Ma, Liu, Liu, Global percentage of asymptomatic SARS-CoV-2 infections among the tested population and individuals with confirmed COVID-19 diagnosis: A systematic review and meta-analysis, JAMA Netw Open,
doi:10.1001/jamanetworkopen.2021.37257Mehta, Bhandari, Raut, Kacimi, Huy, Coronavirus disease (COVID-19): Comprehensive review of clinical presentation, Front Public Health,
doi:10.3389/fpubh.2020.582932Saragih, Saragih, Batubara, Lin, Dementia as a mortality predictor among older adults with COVID-19: A systematic review and meta-analysis of observational study, Geriatr Nurs,
doi:10.1016/j.gerinurse.2021.03.007Schultze, Nightingale, Evans, Mortality among care home residents in England during the first and second waves of the COVID-19 pandemic: an observational study of 4.3 million adults over the age of 65, Lancet Reg Health Eur,
doi:10.1016/j.lanepe.2021.100295Serafini, Bondi, Locatelli, Amore, Aged patients with mental disorders in the COVID-19 Era: The experience of northern Italy, Am J Geriatr Psychiatry,
doi:10.1016/j.jagp.2020.04.015Shah, Varna, Sharma, Mavalankar, Does vitamin D supplementation reduce COVID-19 severity?: A systematic review, Qjm,
doi:10.1093/qjmed/hcac040Solis, Salas, Bartolome, Ballestín, The effects of vitamin D Supplementation in COVID-19 patients: A systematic review, Int J Mol Sci,
doi:10.3390/ijms232012424Taquet, Luciano, Geddes, Harrison, Bidirectional associations between COVID-19 and psychiatric disorder: Retrospective cohort studies of 62 354 COVID-19 cases in the USA, Lancet Psychiatry,
doi:10.1016/S2215-0366(20)30462-4Tehrani, Killander, Astrand, Jakobsson, Gille-Johnson, Risk factors for death in adult COVID-19 patients: Frailty predicts fatal outcome in older patients, Int J Infect Dis,
doi:10.1016/j.ijid.2020.10.071Teshome, Adane, Girma, Mekonnen, The impact of vitamin D level on COVID-19 infection: Systematic review and meta-analysis, Front Public Health,
doi:10.3389/fpubh.2021.624559Wang, Xu, Volkow, Increased risk of COVID-19 infection and mortality in people with mental disorders: Analysis from electronic health records in the United States, World Psychiatry,
doi:10.1002/wps.20806Wynants, Van Calster, Collins, Prediction models for diagnosis and prognosis of covid-19: Systematic review and critical appraisal, BMJ,
doi:10.1136/bmj.m1328Zheng, Peng, Xu, Risk factors of critical & mortal COVID-19 cases: A systematic literature review and meta-analysis, J Infect,
doi:10.1016/j.jinf.2020.04.021Zuin, Guasti, Roncon, Cervellati, Zuliani, Dementia and the risk of death in elderly patients with COVID-19 infection: Systematic review and meta-analysis, Int J Geriatr Psychiatry,
doi:10.1002/gps.5468
