Patients with PTSD at an increased risk for hospitalization, death from COVID-19

Patients with PTSD who were diagnosed with COVID-19 were more likely to be hospitalized or die, compared with those without a psychiatric disorder, researchers reported in Translational Psychiatry.

PTSD is associated with an increased risk for physical illness and early mortality. However, it is unknown if the disorder also increases the risk for adverse outcomes of COVID-19, Kristen Nishimi, PhD, MPH, of the department of psychiatry and behavioral sciences at the University of California, San Francisco, and colleagues wrote.

Nishimi and colleagues conducted a retrospective cohort study that examined the associations of PTSD and other psychiatric disorders with risk for hospitalization and death in the 60 days following a COVID-19 infection.

The authors collected data through the United States Veterans Affairs Corporate Data Warehouse, as well as the VA COVID-19 Shared Data Resource, which contains information on all VA patients who had a COVID-19 test.

Nishimi and colleagues identified a total of 228,367 patients (mean age, 60.6 years; 89.5% male) from the VA who tested positive for COVID-19 between February 2020 and August 2021.

“PTSD is routinely screened in the VA Health Care System, so it may be more reliably detected even for less severe cases, compared with other psychiatric conditions,” Nishimi said in a release from the University of California, San Francisco. “Older veterans, who may have been diagnosed with PTSD many years ago and have chronic PTSD, may have symptoms that are relatively less severe or better managed.”

Of the patients identified, 25.6% had PTSD and 28.2% had a different psychiatric disorder. In the 60 days following a COVID-19 diagnosis, 15% of patients were hospitalized and 6% died.

Patients with PTSD had an increased risk for hospitalization (aRR, 1.18; 95% CI, 1.15-1.21) and death (aRR, 1.13; 95% CI, 1.08-1.19), compared to those with no psychiatric disorders.

Patients with any other psychiatric disorders, compared with no psychiatric disorders, had a higher risk for adverse COVID-19 outcomes, such as hospitalization (aRR, 1.27; 95% CI, 1.24-1.29) and death (aRR, 1.19; 95% CI, 1.15-1.23).

“While other psychiatric conditions have been linked to comorbidities, inflammation and health risk behaviors, PTSD, in particular, is characterized by lower levels of the stress hormone cortisol, which has anti-inflammatory properties that may be beneficial in reducing the inflammatory activity that underlies many adverse outcomes of COVID,” Nishimi said in the release.

References:

Fewer patients with PTSD survive COVID. https://www.ucsf.edu/news/2022/11/424291/fewer-patients-ptsd-survive-covid. Published Nov. 21, 2022. Accessed Dec. 2, 2022.