Influence of Preexisting Psychotic and Bipolar Disorders on the Outcomes of Acutely Hospitalized Patients With COVID-19.

Publication date: Sep 19, 2025

COVID-19 outcomes are often worse among patients with preexisting conditions. The authors assessed the impact of preexisting psychotic and bipolar disorders (PsBPs) on COVID-19 outcomes. A retrospective cohort study was conducted with COVID-19 patients admitted to three medical centers between April 20, 2020, and October 20, 2023. Patients were grouped into individuals with PsBPs (i. e., schizophrenia, other psychotic disorders, and bipolar disorders) and those with no psychiatric disorders (NPDs), defined as individuals without preexisting conditions such as nonpsychotic depression or anxiety. Data on demographic characteristics, clinical features, and COVID-19 severity were collected. The primary outcome was COVID-19 in-hospital mortality rate, and the secondary outcome was the association of PsBPs with COVID-19 severity. Among 7,370 hospitalized COVID-19 patients (43. 7% female; mean age=42. 7 years), 12. 2% had a PsBP. Patients with PsBPs had higher intensive care unit (ICU) admission rates (44. 5% vs. 21. 8%, p=0. 003) and mortality rates (39. 2% vs. 23. 8%, p=0. 045). Time intervals to ICU admission (7. 3 vs. 8. 2 days, p=0. 001) and in-hospital death (8. 0 vs. 12. 2 days, p=0. 001) were significantly shorter in the PsBP group, compared with the NPD group. COVID-19 patients with PsBPs had worse outcomes, including higher ICU admission and mortality rates, and greater disease severity. These findings highlight the importance of early detection and tailored interventions for this vulnerable population.

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