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Schizophrenia Spectrum and Other Psychotic Disorders

Association Between Antipsychotic Use and COVID-19 Mortality Among People With Serious Mental Illness

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To identify the key insights or developments described in this article

1 Credit CME

JAMA Psychiatry

Published Online: September 22, 2021

Research Letter

Article Information and Disclosures

Katlyn Nemani, MD^1,2;

Sarah Conderino, MS³;

Julia Marx, BS¹;

Lorna E. Thorpe, PhD, MPH³;

Donald C. Goff, MD^1,2

Author Affiliations

¹Department of Psychiatry, New York University Langone Medical Center, New York
²Nathan Kline Institute for Psychiatric Research, Orangeburg, New York
³Department of Population Health, New York University Langone Medical Center, New York

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Schizophrenia spectrum disorders are associated with increased mortality in the setting of COVID-19 infection.¹^- 3 Among several possible explanations for this increased risk is the role of adverse effects of antipsychotic medication, which has not been systematically examined in this population. Our goal was to investigate whether antecedent antipsychotic use was associated with mortality among patients with serious mental illness diagnosed with COVID-19.

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Article Information

Accepted for Publication: July 19, 2021.

Published Online: September 22, 2021. doi:10.1001/jamapsychiatry.2021.2503

Corresponding Author: Donald C. Goff, MD, Department of Psychiatry, New York University Langone Medical Center, One Park Avenue, New York, NY 10016 (donald.goff@nyulangone.org).

Author Contributions: Drs Nemani and Goff had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Nemani, Thorpe, Goff.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Nemani, Marx.

Critical revision of the manuscript for important intellectual content: Nemani, Conderino, Thorpe, Goff.

Statistical analysis: Nemani, Conderino, Thorpe.

Administrative, technical, or material support: Marx, Goff.

Supervision: Nemani, Thorpe, Goff.

Conflict of Interest Disclosures: None reported.

References

Nemani K , Li C , Olfson M , et al. Association of psychiatric disorders with mortality among patients with COVID-19. JAMA Psychiatry. 2021;78(4):380-386. doi:10.1001/jamapsychiatry.2020.4442 PubMed Google Scholar Crossref

Bulletin S , Tzur Bitan D , Krieger I , et al. COVID-19 prevalence and mortality among schizophrenia patients: a large-scale retrospective cohort study. Schizophr Bull. Published online February 19, 2021. doi:10.1093/schbul/sbab012 Google Scholar

Fond G , Pauly V , Leone M , et al. Disparities in intensive care unit admission and mortality among patients with schizophrenia and COVID-19: a national cohort study. Schizophr Bull. 2021;47(3):624-634. doi:10.1093/schbul/sbaa158 PubMed Google Scholar Crossref

Walker ER , McGee RE , Druss BG . Mortality in mental disorders and global disease burden implications: a systematic review and meta-analysis. JAMA Psychiatry. 2015;72(4):334-341. doi:10.1001/jamapsychiatry.2014.2502 PubMed Google Scholar Crossref

Reilev M , Kristensen KB , Pottegård A , et al. Characteristics and predictors of hospitalization and death in the first 11 122 cases with a positive RT-PCR test for SARS-CoV-2 in Denmark: a nationwide cohort. Int J Epidemiol. 2020;49(5):1468-1481. doi:10.1093/ije/dyaa140 PubMed Google Scholar Crossref

Poblador-Plou B , Carmona-Pírez J , Ioakeim-Skoufa I , et al; EpiChron Group. Baseline chronic comorbidity and mortality in laboratory-confirmed COVID-19 cases: results from the PRECOVID study in Spain. Int J Environ Res Public Health. 2020;17(14):1-14. doi:10.3390/ijerph17145171 PubMed Google Scholar Crossref

AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
1.00 credit toward the CME [and Self-Assessment requirements] of the American Board of Surgery’s Continuous Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.