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©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
Prevalence and clinical characteristics of COVID-19 in inpatients with schizophrenia in Wuhan, China
Hong-Wei Sheng, Hong-Gang Wang, Chun-Zhi Wang, Jiang Wu, Li-Jian Huo, Ruo-Xi Wang, Yong-Jie Zhou, Xiang-Yang Zhang
Hong-Wei Sheng, Jiang Wu, Department of Psychiatry, Wuhan Youfu Hospital, Wuhan 430070, Hubei Province, China
Hong-Gang Wang, Chun-Zhi Wang, Qingdao Mental Health Center, Qingdao University, Qingdao 266000, Shandong Province, China
Li-Jian Huo, Xiang-Yang Zhang, CAS Key Laboratory of Mental Health, Chinese Academy of Sciences, Beijing 10000, China
Ruo-Xi Wang, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430070, Hubei Province, China
Yong-Jie Zhou, Department of Psychiatric Rehabilitation, Shenzhen Kangning Hospital, Shenzhen 510810, Guangdong Province, China
Author contributions: Zhang XY, Zhou YJ, and Sheng HW designed the study; Sheng HY, Wu J, Huo LJ, and Huang W were responsible for collecting the clinical data; Wang HG and Wang CZ collected the literature and cleaned the data; Zhou YJ and Zeng LY did statistical analysis; Zhou YJ and Sheng HW wrote the manuscript; Zhang XY reviewed and revised the manuscript.
Institutional review board statement: The investigation was carried out in accordance with the latest version of the Declaration of Helsinki. The Wuhan Youfu Hospital received approval for this study from the institutional review board of the Institute of Psychology, Chinese Academy of Sciences. Given the urgent need for data collection and retrospective research, no written informed consent was required for these current analyses.
Conflict-of-interest statement: There are no conflicts of interest related to this article.
Data sharing statement: The data that support the findings of this study are available from the corresponding author Yongjie Zhou upon reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
http://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Xiang-Yang Zhang, MD, PhD, CAS Key Laboratory of Mental Health, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing 10000, China. zhangxy@psych.ac.cn
Received: February 13, 2021
Peer-review started: February 13, 2021
First decision: March 16, 2021
Revised: March 29, 2021
Accepted: November 24, 2021
Article in press: November 24, 2021
Published online: January 19, 2022
BACKGROUND
In contrast to many Western countries, China has maintained its large psychiatric hospitals. The prevalence and clinical characteristics of coronavirus disease 2019 (COVID-19) in inpatients with schizophrenia (SCZ) are unclear.
AIM
To assess the prevalence of COVID-19 among inpatients with SCZ and compare the infected to uninfected SCZ patients in a Wuhan psychiatric hospital.
METHODS
We retrospectively collected demographic characteristics and clinical profiles of all SCZ patients with COVID-19 at Wuhan’s Youfu Hospital.
RESULTS
Among the 504 SCZ patients, 84 had COVID-19, and we randomly sampled 174 who were uninfected as a comparison group. The overall prevalence of COVID-19 in SCZ patients was 16.7%. Among the 84 SCZ patients with confirmed COVID-19, the median age was 54 years and 76.2% were male. The most common symptom was fever (82%), and less common symptoms were cough (31%), poor appetite (20%), and fatigue (16%). Compared with SCZ patients without COVID-19, those with COVID-19 were older (P = 0.006) and significantly lighter (P = 0.002), and had more comorbid physical diseases (P = 0.001). Surprisingly, those infected were less likely to be smokers (< 0.001) or to be treated with clozapine (P = 0.03). Further logistic regression showed that smoking [odds ratio (OR) = 5.61], clozapine treated (OR = 2.95), and male (OR = 3.48) patients with relatively fewer comorbid physical diseases (OR = 0.098) were at a lower risk for COVID-19. SCZ patients with COVID-19 presented primarily with fever, but only one-third had a cough, which might otherwise be the most common mode of transmission between individuals.
CONCLUSION
Two unexpected protective factors for COVID-19 among SCZ inpatients are smoking and clozapine treatment.
Core Tip: In contrast to many Western countries, China has maintained its large psychiatric hospitals. The prevalence and clinical characteristics of coronavirus disease 2019 (COVID-19) in inpatients with schizophrenia (SCZ) are unclear. Our aim was to assess the prevalence of COVID-19 among inpatients with SCZ and compare the infected to uninfected SCZ patients in a Wuhan psychiatric hospital. Two unexpected protective factors for COVID-19 among SCZ inpatients are smoking and clozapine treatment.
