COVID-19 patients managed in psychiatric inpatient settings due to first-episode mental disorders in Wuhan, China: clinical characteristics, treatments, outcomes, and our experiences

• DOI: 10.1038/s41398-020-01022-x
• Publication Date: 2020-10-02T14:03:13Z
• Authors: Qin Xie; Fang Fan; Xue-Peng Fan; Xiao-Jiang Wang; Ming-Jian Chen; Bao-Liang Zhong; Helen Fung-Kum Chiu
• Keywords: Wuhan; Male; China; Pneumonia, Viral; Comorbidity; Mental disorders; Article; Psychiatric inpatient; Cellular and Molecular Neuroscience; Betacoronavirus; 03 medical and health sciences; 0302 clinical medicine; Síndrome respiratorio agudo grave; Electronic Health Records; Humans; Pandemics; Biological Psychiatry; Psychiatric Status Rating Scales; Psychotropic Drugs; Clinical characteristics; SARS-CoV-2; Mental Disorders; COVID-19; Middle Aged; Prognosis; COVID-19 patients; Patient Care Management; 3. Good health; Coronavirus; Hospitalization; Psychiatry and Mental health; Female; Symptom Assessment; Coronavirus Infections

AbstractData are scarce regarding the comorbid mental disorders and their management among COVID-19 patients. This study described the clinical characteristics and management of COVID-19 patients treated in psychiatric inpatient settings due to comorbid first-onset mental disorders in Wuhan, China. This electronic medical records-based study included 25 COVID-19 patients with first-onset mental disorders and 55 patients with first-onset mental disorders without COVID-19 (control group). Data collected included ICD-10 diagnoses of mental disorders, psychiatric and respiratory symptoms, treatments, and outcomes. Adjustment disorder (n = 11, 44.0%) and acute and transient psychotic disorders, with associated acute stress (n = 6, 24.0%) were main clinical diagnoses in the COVID-19 group while serious mental illnesses (i.e., schizophrenia, 24.5%) and alcohol use disorders (10.9%) were overrepresented in the control group. On admission, the most common psychiatric symptom in COVID-19 patients was insomnia symptoms (n = 18, 72.0%), followed by aggressive behaviors (n = 16, 64.0%), delusion (n = 10, 40.0%), and severe anxiety (n = 9, 36.0%). In addition to respiratory treatments, 76.0% COVID-19 patients received antipsychotics, 40.0% sedative-hypnotics, and 24.0% mood stabilizers. At the end of inpatient treatment, 4 (16.0%) COVID-19 patients were transferred to other hospitals to continue respiratory treatment after their psychiatric symptoms were controlled while the remaining 21 (84.0%) all recovered. Compared to the control group, COVID-19 group had significantly shorter length of hospital stay (21.2 vs. 37.4 days, P < 0.001). Adjustment disorder and acute and transient psychotic disorders are the main clinical diagnoses of COVID-19 patients managed in psychiatric inpatient settings. The short-term prognosis of these patients is good after conventional psychotropic treatment.