ArticleEuropean psychiatry : the journal of the Association of European Psychiatrists2025
Identifying psychiatric morbidity and comorbidity patterns associated with COVID-19 mortality. A register-based cohort study from Catalonia.
Article in European psychiatry : the journal of the Association of European Psychiatrists, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThere is limited evidence on the association between psychiatric morbidity and COVID-19 mortality.
methodsWe used deidentified electronic health records from the Catalan public health system to evaluate the association between number of mental disorders and COVID-19 mortality. Adults diagnosed with a mental disorder in Catalonia's mental health services (from to 2017-2019) were compared to a matched (1:1) control group by sex, age, and area of residence. COVID-19 mortality risk was evaluated from February to December 2020. Odds ratios (OR) with 95% confidence intervals (CI) were estimated for the association between the number of mental disorders and COVID-19 mortality. To examine if different patterns of psychiatric comorbidity were related to COVID-19 death, we performed K-means cluster analysis on individuals with ≥2 disorders, stratified by COVID-19 death.
resultsThe final sample included 785,378 adults (392,689 with ≥1 mental disorder). Mortality risk increased with the number of mental disorders: OR 1.23 (95% CI: 1.11-1.35) for one mental disorder, up to 5.21 (95% CI: 1.34-20.27) for four or more. Cluster analysis (n=84,207) identified seven psychiatric comorbidity profiles among those who did not die of COVID-19, and six profiles among those who died, with substantial comparability between cohorts.
conclusionAn increasing number of psychiatric diagnoses was associated with greater COVID-19 mortality, while specific comorbidity patterns showed limited differential influence. This suggests that it is not the specific combination of mental disorders that influences COVID-19 death outcomes, but rather the overall burden of multiple diagnoses.
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