COVID-19 Infection in an Inpatient Psychiatric Hospital Setting: Demographics, Outcomes, and Impact on Well-being

Gwen Levitt, DO, DFAPA^a,b,c,d,e

Prim Care Companion CNS Disord 2021;23(5):21m03003

ABSTRACT

Objective: The mental health community expected that seriously mentally ill (SMI) patients would be especially vulnerable to coronavirus disease 2019 (COVID-19) infection due to a higher medical comorbidity rate than the general population and disparities in access to medical care. Concern was voiced as to the impact on the psychiatric stability of this population due to anxiety about the pandemic, recommended isolation, and limited in-person interactions with treatment providers and support systems. The objective of this study was to evaluate the impact of COVID-19 on a cohort of involuntarily hospitalized SMI patients.

Methods: The electronic medical records from March 28 through December 31, 2020 of all COVID-positive psychiatric inpatients were retrospectively reviewed. No outpatients or readmissions were included in the sample.

Results: During the study period 238, COVID-positive inpatients were identified out of approximately 12,859 discreet admissions. The sample consisted of 158 men (66%) and 80 women (34%). The mean age of positive patients was 41 years. Eight patients (3%) required medical hospitalizations related to COVID-19, with 1 death. Ninety-seven patients (41%) had at least 1 or more of the known medical comorbidities related to increased risk for COVID-19 infection. Seclusion, restraints, and administration of as-needed medications (PRN) for anxiety or psychotic agitation occurred less frequently in the COVID-positive patients compared to those without infection.

Conclusions: Medical hospitalizations were infrequent in the study sample. Medical comorbidities were much higher in this group relative to statewide data. Seclusion, restraint, and PRN administration were lower in the COVID-positive cohort compared to COVID-negative inpatients. Overall, the sample group did not experience significant negative outcomes as might have been expected for this population.

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