PDF(Pubmed)
Abstract：
Psychological disturbances are frequent following COVID-19. However, there is not much information about whether pre-existing psychological disorders are associated with the severity and evolution of COVID-19. We aimed to explore the associations between regular psychotropic medication use (PM) before infection as a proxy for mood or anxiety disorders with COVID-19 recovery trajectories. We used data from the Predi-COVID study. We followed adults, tested positive for SARS-CoV-2 and collected demographics, clinical characteristics, comorbidities and daily symptoms 14 days after inclusion. We calculated a score based on 16 symptoms and modeled latent class trajectories. We performed polynomial logistic regression with PM as primary exposure and the different trajectories as outcome. We included 791 participants, 51% were men, and 5.3% reported regular PM before infection. We identified four trajectories characterizing recovery dynamics: \"Almost asymptomatic,\" \"Quick recovery,\" \"Slow recovery,\" and \"Persisting symptoms\". With a fully adjusted model for age, sex, socioeconomic, lifestyle and comorbidity, we observed associations between PM with the risks of being in more severe trajectories than \"Almost Asymptomatic\": \"Quick recovery\" (relative risk (95% confidence intervals) 3.1 (2.7, 3.4), \"Slow recovery\" 5.2 (3.0, 9.2), and \"Persisting symptoms\"11.7 (6.9, 19.6) trajectories. We observed a gradient of risk between PM before the infection and the risk of slow or no recovery in the first 14 days. These results suggest that a pre-existing psychological condition increases the risk of a poorer evolution of COVID-19 and may increase the risk of Long COVID. Our findings can help to personalize the care of people with COVID-19.
摘要：
COVID-19后心理障碍很常见。然而,关于先前存在的心理障碍是否与COVID-19的严重程度和演变相关的信息不多。我们旨在探讨感染前常规使用精神药物（PM）作为情绪或焦虑症与COVID-19恢复轨迹的替代指标之间的关联。我们使用了Predi-COVID研究的数据。我们跟踪成年人，SARS-CoV-2检测呈阳性，并收集了人口统计数据，临床特征,纳入后14天的合并症和每日症状。我们根据16种症状计算了一个分数，并对潜在的类轨迹进行了建模。我们进行了多项式逻辑回归，以PM为主要暴露量，以不同的轨迹为结果。我们包括791名参与者，51%是男性,5.3%的患者在感染前报告有规律的PM。我们确定了四种表征恢复动态的轨迹：“几乎无症状，\"\"快速恢复,\"\"恢复缓慢,\"和\"持续症状\"。有了一个完全调整的年龄模型，性别,社会经济,生活方式和合并症，我们观察到PM与处于更严重轨迹的风险之间的关联比“几乎无症状”：“快速恢复”（相对风险（95％置信区间）3.1（2.7，3.4），“缓慢恢复”5.2（3.0，9.2），和“持续症状”11.7（6.9，19.6）轨迹。我们观察到感染前PM与前14天恢复缓慢或无恢复的风险之间的风险梯度。这些结果表明，预先存在的心理状况会增加COVID-19进化较差的风险，并可能增加长COVID的风险。我们的发现有助于对COVID-19患者进行个性化护理。
