Issue link: https://beckershealthcare.uberflip.com/i/1446606
19 PATIENT SAFETY & OUTCOMES People with certain mental illnesses have higher COVID-19 risk — here's why By Gabrielle Masson B efore COVID-19 booster shots were authorized for all adults, the U.S. gov- ernment had already recommended boosters for Americans with certain high- risk conditions, including mental health conditions. e decision came aer numer- ous studies linked mental health disorders to a higher COVID-19 risk and more severe outcomes, NPR reported Nov. 22. One study, conducted at Yale New Haven (Conn.) Health System, included data from 1,685 COVID-19 patients hospitalized be- tween Feb. 15 and April 25, 2020, along with a May 27, 2020 follow-up. e data didn't include treatment information. Of the 1,685 patients, 473 (28 percent) had received psychiatric diagnoses before the ad- mission. Patients with psychiatric diagnoses were more likely to be older, female, white and have medical comorbidities (malignant cancer, cerebrovascular disease, congestive heart failure, diabetes, kidney disease, liver disease, myocardial infarction and/or HIV). Overall, 318 patients (18.9 percent) died. Researchers found that patients with a psy- chiatric diagnosis had a higher COVID-19 mortality rate compared to those with no psychiatric diagnosis, even aer controlling for demographic characteristics, other med- ical comorbidities and hospital location. e risk of death from COVID-19 went up 50 percent for those with a history of mental ill- ness, said Luming Li, MD, a psychiatrist who had been working at Yale University at the time and is now CMO at the Harris Center for Mental Health and IDD in Houston. Another study published in October 2020 examined a national EHR database and found individuals with any history of a mental disorder were more likely to get COVID-19, Nora Volkow, MD, study author and director of the National Institute on Drug Abuse, told NPR. "And if they got infected, then they were more likely to have negative outcomes, such as hospitalization and death," she said. ere are many reasons psychiatric illness may be tied to an increased COVID-19 mortality risk. Mental illnesses may change people's behaviors to make them less likely to protect themselves from an infection using measures like social distancing or mask-wearing. Individuals with mental illness also tend to have poorer overall health and chronic health issues. Addition- ally, many medications used to treat mental illnesses, particularly antipsychotics, can increase the risk of chronic health problems, Dr. Volkow told NPR. e risk is higher for people with serious mental illness, but it must be remembered that mental illness is not static; it is constantly changing. n COVID-19-fueled hospital strain tied to thousands of excess deaths, CDC finds By Erica Carbajal A CDC analysis published Nov. 18 predicts that when the nationwide intensive care unit bed capacity hits or exceeds 75 percent, thousands of additional excess deaths occur over the following two weeks. Using CDC data on excess deaths from all causes and HHS data on hospital strain, the agency's Cybersecurity & Infrastructure Security Agency COVID Task Force evaluated the link between hospital strain and excess deaths between July 2020 and July 2021. Excess deaths were defined as the differences between the observed and expected num- ber of deaths during specific periods, and a model was used to calculate the estimated number of deaths. When the country's ICU bed use reaches 75 percent ca- pacity, the study predicts an estimated 12,000 additional excess deaths would occur within two weeks. When the nation's hospitals exceed 100 percent ICU bed capac- ity, the study estimates 80,000 excess deaths could be expected in the following two weeks. For both capacity limits, even more deaths could be expected at four and six weeks, the study estimates. "This analysis indicates the importance of controlling case growth and subsequent hospitalizations before severe strain," the CDC analysis said. As of Nov. 18, about 78 percent of the nation's ICU beds were in use, HHS data shows. In the analysis, re- searchers cited the data through Oct. 25, which showed nationwide adult ICU capacity had exceeded 75 per- cent for at least 12 weeks. "This means that the United States continues to expe- rience the high and sustained levels of hospital strain that, according to the model's results, are associated with significant subsequent increases in excess deaths," the study said. n ere are many reasons psychiatric illness may be tied to an increased COVID-19 mortality risk.