People with psychiatric illnesses are more at risk of developing a severe form of Covid-19 and of dying from it, shows a study whose authors call for the priority to be vaccinated in these patients.

This poorer prognosis could be explained by the "obstacles to medical care" encountered, "immuno-inflammatory alterations linked to psychiatric disorders" themselves or by the impact of the treatments taken by these patients, argue two of the authors in a report. press release published Monday by the FondaMental Foundation, a network of researchers on psychiatric illnesses.

Reduced access to care for mental disorders

This article, which synthesizes 33 studies published on the subject in 22 countries, concludes that patients with mental disorders are twice as likely to die from Covid in the event of infection compared to other patients. This association is found in particular for psychotic disorders, mood disorders, addictions and mental retardation, but not for anxiety disorders. The fact of receiving treatment with antipsychotics, anxiolytics or antidepressants is associated with a high risk of excess mortality (multiplied by 3.7, 2.6 and 2.2 respectively).

The study, published on July 15 in the British journal

The Lancet Psychiatry

, also shows that patients with mental disorders are 2.2 times more likely to be hospitalized in the event of Covid but are not more frequently admitted to care. intensive.

"We know that these patients face significant barriers to medical care and our results suggest that reduced access to care may have contributed to the increased mortality observed in this group," said one of the authors, Livia De Picker, from the University Psychiatric Hospital Campus Duffel (Belgium).

Treatments singled out

Other hypotheses, this increased risk could "reflect biological processes such as immuno-inflammatory alterations linked to psychiatric disorders", while "antipsychotic treatments could increase cardiovascular and thromboembolic risks, interfere with an immune response and cause interactions with drugs. used to treat Covid-19, ”adds Marion Leboyer, director of the FondaMental Foundation.

"Our results highlight the need for targeted approaches to manage and prevent Covid-19 in the groups of patients at risk identified in this study", argue the authors.

"Public health authorities must take targeted measures to ensure maximum vaccination" of these patients and "fight against a possible reduction in access to care," said Dr De Picker in particular.

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