Association between mental illness and COVID-19 susceptibility and clinical outcomes in South Korea: a nationwide cohort study
Evidence for the associations between mental illness and the likelihood of a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test result and the clinical outcomes of COVID-19 is scarce. We aimed to investigate these associations with data from a national register in South Korea...
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Veröffentlicht in: | The Lancet. Psychiatry 2020-12, Vol.7 (12), p.1025-1031 |
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creator | Lee, Seung Won Yang, Jee Myung Moon, Sung Yong Yoo, In Kyung Ha, Eun Kyo Kim, So Young Park, Un Min Choi, Sejin Lee, Sang-Hyuk Ahn, Yong Min Kim, Jae-Min Koh, Hyun Yong Yon, Dong Keon |
description | Evidence for the associations between mental illness and the likelihood of a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test result and the clinical outcomes of COVID-19 is scarce. We aimed to investigate these associations with data from a national register in South Korea.
A nationwide cohort study with propensity score matching was done in South Korea using data collected from the Health Insurance Review and Assessment Service of Korea. We defined mental illness as present if one of the relevant ICD-10 codes was recorded at least twice within 1 year for an outpatient or inpatient. Severe mental illness was considered as non-affective or affective disorders with psychotic features. We included all patients aged older than 20 years who were tested for SARS-CoV-2 through services facilitated by the Korea Centers for Disease Control and Prevention, the Health Insurance Review and Assessment Service of Korea, and the Ministry of Health and Welfare, South Korea. We investigated the primary outcome (SARS-CoV-2 test positivity) in the entire cohort and the secondary outcomes (severe clinical outcomes of COVID-19: death, admission to the intensive care unit, or invasive ventilation) among those who tested positive.
Between Jan 1 and May 15, 2020, 216 418 people were tested for SARS-CoV-2, of whom 7160 (3·3%) tested positive. In the entire cohort with propensity score matching, 1391 (3·0%) of 47 058 patients without a mental illness tested positive for SARS-CoV-2, compared with 1383 (2·9%) of 48 058 with a mental illness (adjusted odds ratio [OR] 1·00, 95% CI 0·93–1·08). Among the patients who tested positive for SARS-CoV-2, after propensity score matching, 109 (8·3%) of 1320 patients without a mental illness had severe clinical outcomes of COVID-19 compared with 128 (9·7%) of 1320 with a mental illness (adjusted OR 1·27, 95% CI 1·01–1·66).
Diagnosis of a mental illness was not associated with increased likelihood of testing positive for SARS-CoV-2. Patients with a severe mental illness had a slightly higher risk for severe clinical outcomes of COVID-19 than patients without a history of mental illness. Clinicians treating patients with COVID-19 should be aware of the risk associated with pre-existing mental illness.
National Research Foundation of Korea. |
doi_str_mv | 10.1016/S2215-0366(20)30421-1 |
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A nationwide cohort study with propensity score matching was done in South Korea using data collected from the Health Insurance Review and Assessment Service of Korea. We defined mental illness as present if one of the relevant ICD-10 codes was recorded at least twice within 1 year for an outpatient or inpatient. Severe mental illness was considered as non-affective or affective disorders with psychotic features. We included all patients aged older than 20 years who were tested for SARS-CoV-2 through services facilitated by the Korea Centers for Disease Control and Prevention, the Health Insurance Review and Assessment Service of Korea, and the Ministry of Health and Welfare, South Korea. We investigated the primary outcome (SARS-CoV-2 test positivity) in the entire cohort and the secondary outcomes (severe clinical outcomes of COVID-19: death, admission to the intensive care unit, or invasive ventilation) among those who tested positive.
Between Jan 1 and May 15, 2020, 216 418 people were tested for SARS-CoV-2, of whom 7160 (3·3%) tested positive. In the entire cohort with propensity score matching, 1391 (3·0%) of 47 058 patients without a mental illness tested positive for SARS-CoV-2, compared with 1383 (2·9%) of 48 058 with a mental illness (adjusted odds ratio [OR] 1·00, 95% CI 0·93–1·08). Among the patients who tested positive for SARS-CoV-2, after propensity score matching, 109 (8·3%) of 1320 patients without a mental illness had severe clinical outcomes of COVID-19 compared with 128 (9·7%) of 1320 with a mental illness (adjusted OR 1·27, 95% CI 1·01–1·66).
Diagnosis of a mental illness was not associated with increased likelihood of testing positive for SARS-CoV-2. Patients with a severe mental illness had a slightly higher risk for severe clinical outcomes of COVID-19 than patients without a history of mental illness. Clinicians treating patients with COVID-19 should be aware of the risk associated with pre-existing mental illness.
National Research Foundation of Korea.</description><identifier>ISSN: 2215-0366</identifier><identifier>EISSN: 2215-0374</identifier><identifier>DOI: 10.1016/S2215-0366(20)30421-1</identifier><identifier>PMID: 32950066</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Cohort Studies ; Comorbidity ; COVID-19 - epidemiology ; Disease Susceptibility ; Female ; Humans ; Male ; Mental Disorders - epidemiology ; Middle Aged ; National Health Programs - statistics & numerical data ; Propensity Score ; Republic of Korea - epidemiology ; Risk ; Severity of Illness Index</subject><ispartof>The Lancet. Psychiatry, 2020-12, Vol.7 (12), p.1025-1031</ispartof><rights>2020 Elsevier Ltd</rights><rights>Copyright © 2020 Elsevier Ltd. All rights reserved.</rights><rights>2020 Elsevier Ltd. All rights reserved. 2020 Elsevier Ltd</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c613t-a1cef2e08c8ec329ad8e781668281efeff43d82fae4f0f740179f5a1426947503</citedby><cites>FETCH-LOGICAL-c613t-a1cef2e08c8ec329ad8e781668281efeff43d82fae4f0f740179f5a1426947503</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,778,782,883,27911,27912</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32950066$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lee, Seung Won</creatorcontrib><creatorcontrib>Yang, Jee Myung</creatorcontrib><creatorcontrib>Moon, Sung Yong</creatorcontrib><creatorcontrib>Yoo, In Kyung</creatorcontrib><creatorcontrib>Ha, Eun Kyo</creatorcontrib><creatorcontrib>Kim, So Young</creatorcontrib><creatorcontrib>Park, Un Min</creatorcontrib><creatorcontrib>Choi, Sejin</creatorcontrib><creatorcontrib>Lee, Sang-Hyuk</creatorcontrib><creatorcontrib>Ahn, Yong Min</creatorcontrib><creatorcontrib>Kim, Jae-Min</creatorcontrib><creatorcontrib>Koh, Hyun Yong</creatorcontrib><creatorcontrib>Yon, Dong Keon</creatorcontrib><title>Association between mental illness and COVID-19 susceptibility and clinical outcomes in South Korea: a nationwide cohort study</title><title>The Lancet. Psychiatry</title><addtitle>Lancet Psychiatry</addtitle><description>Evidence for the associations between mental illness and the likelihood of a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test result and the clinical outcomes of COVID-19 is scarce. We aimed to investigate these associations with data from a national register in South Korea.
A nationwide cohort study with propensity score matching was done in South Korea using data collected from the Health Insurance Review and Assessment Service of Korea. We defined mental illness as present if one of the relevant ICD-10 codes was recorded at least twice within 1 year for an outpatient or inpatient. Severe mental illness was considered as non-affective or affective disorders with psychotic features. We included all patients aged older than 20 years who were tested for SARS-CoV-2 through services facilitated by the Korea Centers for Disease Control and Prevention, the Health Insurance Review and Assessment Service of Korea, and the Ministry of Health and Welfare, South Korea. We investigated the primary outcome (SARS-CoV-2 test positivity) in the entire cohort and the secondary outcomes (severe clinical outcomes of COVID-19: death, admission to the intensive care unit, or invasive ventilation) among those who tested positive.
Between Jan 1 and May 15, 2020, 216 418 people were tested for SARS-CoV-2, of whom 7160 (3·3%) tested positive. In the entire cohort with propensity score matching, 1391 (3·0%) of 47 058 patients without a mental illness tested positive for SARS-CoV-2, compared with 1383 (2·9%) of 48 058 with a mental illness (adjusted odds ratio [OR] 1·00, 95% CI 0·93–1·08). Among the patients who tested positive for SARS-CoV-2, after propensity score matching, 109 (8·3%) of 1320 patients without a mental illness had severe clinical outcomes of COVID-19 compared with 128 (9·7%) of 1320 with a mental illness (adjusted OR 1·27, 95% CI 1·01–1·66).
Diagnosis of a mental illness was not associated with increased likelihood of testing positive for SARS-CoV-2. Patients with a severe mental illness had a slightly higher risk for severe clinical outcomes of COVID-19 than patients without a history of mental illness. Clinicians treating patients with COVID-19 should be aware of the risk associated with pre-existing mental illness.
National Research Foundation of Korea.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cohort Studies</subject><subject>Comorbidity</subject><subject>COVID-19 - epidemiology</subject><subject>Disease Susceptibility</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Mental Disorders - epidemiology</subject><subject>Middle Aged</subject><subject>National Health Programs - statistics & numerical data</subject><subject>Propensity Score</subject><subject>Republic of Korea - epidemiology</subject><subject>Risk</subject><subject>Severity of Illness Index</subject><issn>2215-0366</issn><issn>2215-0374</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFUU1v1DAQtRCIVqU_AeRjOaSMHcdJOICqLYWKSj0UuFpeZ8waJfZiO632wm_H3V1WcOJke-Z9jOcR8pLBOQMm39xxzpoKainPOLyuQXBWsSfkeF9uxdPDXcojcprSDwBgtYCmFc_JUc37BkDKY_LrIqVgnM4ueLrE_IDo6YQ-65G6cfSYEtV-oIvbb9eXFetpmpPBdXZLN7q82fbM6LwzhRDmbMKEiTpP78pjRT-HiPot1dRvHR7cgNSEVYiZpjwPmxfkmdVjwtP9eUK-Xn34svhU3dx-vF5c3FRGsjpXmhm0HKEzHZoyvB46bDsmZcc7hhatFfXQcatRWLCtANb2ttFMcNmLtoH6hLzb6a7n5YSDKR-MelTr6CYdNypop_7teLdS38O9akXfcSaLwNleIIafM6asJlcWMY7aY5iT4kIICT0HUaDNDmpiSCmiPdgwUI_xqW186jEbxUFt41Os8F79PeOB9SesAni_A2DZ1L3DqJJx6A0OLqLJagjuPxa_AUbSrBo</recordid><startdate>20201201</startdate><enddate>20201201</enddate><creator>Lee, Seung Won</creator><creator>Yang, Jee Myung</creator><creator>Moon, Sung Yong</creator><creator>Yoo, In Kyung</creator><creator>Ha, Eun Kyo</creator><creator>Kim, So Young</creator><creator>Park, Un Min</creator><creator>Choi, Sejin</creator><creator>Lee, Sang-Hyuk</creator><creator>Ahn, Yong Min</creator><creator>Kim, Jae-Min</creator><creator>Koh, Hyun Yong</creator><creator>Yon, Dong Keon</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20201201</creationdate><title>Association between mental illness and COVID-19 susceptibility and clinical outcomes in South Korea: a nationwide cohort study</title><author>Lee, Seung Won ; Yang, Jee Myung ; Moon, Sung Yong ; Yoo, In Kyung ; Ha, Eun Kyo ; Kim, So Young ; Park, Un Min ; Choi, Sejin ; Lee, Sang-Hyuk ; Ahn, Yong Min ; Kim, Jae-Min ; Koh, Hyun Yong ; Yon, Dong Keon</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c613t-a1cef2e08c8ec329ad8e781668281efeff43d82fae4f0f740179f5a1426947503</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cohort Studies</topic><topic>Comorbidity</topic><topic>COVID-19 - epidemiology</topic><topic>Disease Susceptibility</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Mental Disorders - epidemiology</topic><topic>Middle Aged</topic><topic>National Health Programs - statistics & numerical data</topic><topic>Propensity Score</topic><topic>Republic of Korea - epidemiology</topic><topic>Risk</topic><topic>Severity of Illness Index</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lee, Seung Won</creatorcontrib><creatorcontrib>Yang, Jee Myung</creatorcontrib><creatorcontrib>Moon, Sung Yong</creatorcontrib><creatorcontrib>Yoo, In Kyung</creatorcontrib><creatorcontrib>Ha, Eun Kyo</creatorcontrib><creatorcontrib>Kim, So Young</creatorcontrib><creatorcontrib>Park, Un Min</creatorcontrib><creatorcontrib>Choi, Sejin</creatorcontrib><creatorcontrib>Lee, Sang-Hyuk</creatorcontrib><creatorcontrib>Ahn, Yong Min</creatorcontrib><creatorcontrib>Kim, Jae-Min</creatorcontrib><creatorcontrib>Koh, Hyun Yong</creatorcontrib><creatorcontrib>Yon, Dong Keon</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The Lancet. Psychiatry</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lee, Seung Won</au><au>Yang, Jee Myung</au><au>Moon, Sung Yong</au><au>Yoo, In Kyung</au><au>Ha, Eun Kyo</au><au>Kim, So Young</au><au>Park, Un Min</au><au>Choi, Sejin</au><au>Lee, Sang-Hyuk</au><au>Ahn, Yong Min</au><au>Kim, Jae-Min</au><au>Koh, Hyun Yong</au><au>Yon, Dong Keon</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association between mental illness and COVID-19 susceptibility and clinical outcomes in South Korea: a nationwide cohort study</atitle><jtitle>The Lancet. Psychiatry</jtitle><addtitle>Lancet Psychiatry</addtitle><date>2020-12-01</date><risdate>2020</risdate><volume>7</volume><issue>12</issue><spage>1025</spage><epage>1031</epage><pages>1025-1031</pages><issn>2215-0366</issn><eissn>2215-0374</eissn><abstract>Evidence for the associations between mental illness and the likelihood of a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test result and the clinical outcomes of COVID-19 is scarce. We aimed to investigate these associations with data from a national register in South Korea.
A nationwide cohort study with propensity score matching was done in South Korea using data collected from the Health Insurance Review and Assessment Service of Korea. We defined mental illness as present if one of the relevant ICD-10 codes was recorded at least twice within 1 year for an outpatient or inpatient. Severe mental illness was considered as non-affective or affective disorders with psychotic features. We included all patients aged older than 20 years who were tested for SARS-CoV-2 through services facilitated by the Korea Centers for Disease Control and Prevention, the Health Insurance Review and Assessment Service of Korea, and the Ministry of Health and Welfare, South Korea. We investigated the primary outcome (SARS-CoV-2 test positivity) in the entire cohort and the secondary outcomes (severe clinical outcomes of COVID-19: death, admission to the intensive care unit, or invasive ventilation) among those who tested positive.
Between Jan 1 and May 15, 2020, 216 418 people were tested for SARS-CoV-2, of whom 7160 (3·3%) tested positive. In the entire cohort with propensity score matching, 1391 (3·0%) of 47 058 patients without a mental illness tested positive for SARS-CoV-2, compared with 1383 (2·9%) of 48 058 with a mental illness (adjusted odds ratio [OR] 1·00, 95% CI 0·93–1·08). Among the patients who tested positive for SARS-CoV-2, after propensity score matching, 109 (8·3%) of 1320 patients without a mental illness had severe clinical outcomes of COVID-19 compared with 128 (9·7%) of 1320 with a mental illness (adjusted OR 1·27, 95% CI 1·01–1·66).
Diagnosis of a mental illness was not associated with increased likelihood of testing positive for SARS-CoV-2. Patients with a severe mental illness had a slightly higher risk for severe clinical outcomes of COVID-19 than patients without a history of mental illness. Clinicians treating patients with COVID-19 should be aware of the risk associated with pre-existing mental illness.
National Research Foundation of Korea.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>32950066</pmid><doi>10.1016/S2215-0366(20)30421-1</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Adult Aged Aged, 80 and over Cohort Studies Comorbidity COVID-19 - epidemiology Disease Susceptibility Female Humans Male Mental Disorders - epidemiology Middle Aged National Health Programs - statistics & numerical data Propensity Score Republic of Korea - epidemiology Risk Severity of Illness Index |
title | Association between mental illness and COVID-19 susceptibility and clinical outcomes in South Korea: a nationwide cohort study |
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