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Prevalence of COVID-19 and Psychotropic Drug Treatment in Psychiatric In-patients in Germany in 2020: Results from a Nationwide Pilot Survey.

Pharmacopsychiatry

Authors: Juliane K Mueller, Kira F Ahrens, Michael Bauer, Bernhard T Baune, Stefan Borgwardt, Jürgen Deckert, Katharina Domschke, Regina Ellwanger, Andreas Fallgatter, Thomas Frodl, Jürgen Gallinat, René Gottschalk, Hans J Grabe, Alkomiet Hasan, Sabine C Herpertz, Rene Hurlemann, Frank Jessen, Joseph Kambeitz, Tilo Kircher, Johannes Kornhuber, Klaus Lieb, Andreas Meyer-Lindenberg, Rainer Rupprecht, Norbert Scherbaum, Christiane Schlang, Anja Schneider, Georg Schomerus, Andreas Thoma, Stefan Unterecker, Martin Walter, Henrik Walter, Andreas Reif, Christine Reif-Leonhard

INTRODUCTION: In patients with a pre-existing mental disorder, an increased risk for a first manifestation of a psychiatric disorder in COVID-19 patients, a more severe course of COVID-19 and an increased mortality have been described. Conversely, observations of lower COVID-19 incidences in psychiatric in-patients suggested protective effects of psychiatric treatment and/or psychotropic drugs against COVID-19.

METHODS: A retrospective multi-center study was conducted in 24 German psychiatric university hospitals. Between April and December 2020 (the first and partly second wave of COVID-19), the effects of COVID-19 were assessed on psychiatric in-patient care, the incidence and course of a SARS-CoV-2 infection, and treatment with psychotropic drugs.

RESULTS: Patients (n=36,322) were admitted to the hospitals. Mandatory SARS-CoV-2 tests before/during admission were reported by 23 hospitals (95.8%), while 18 (75%) conducted regular testing during the hospital stay. Two hundred thirty-two (0.6%) patients were tested SARS-CoV-2-positive. Thirty-seven (16%) patients were receiving medical treatment for COVID-19 at the psychiatric hospital, ten (4.3%) were transferred to an intermediate/intensive care unit, and three (1.3%) died. The most common prescription for SARS-CoV-2-positive patients was for second-generation antipsychotics (n=79, 28.2%) and antidepressants (SSRIs (n=38, 13.5%), mirtazapine (n=36, 12.9%) and SNRIs (n=29, 10.4%)).

DISCUSSION: Contrary to previous studies, our results showed a low number of infections and mortality in SARS-CoV-2-positive psychiatric patients. Several preventive measures seem effective to protect this vulnerable group. Our observations are compatible with the hypothesis of a protective effect of psychotropic drugs against COVID-19 as the overall mortality and need for specific medical treatment was low.

Thieme. All rights reserved.

PMID: 37944561

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