Table_1_Association between use of psychotropic medications prior to SARS-COV-2 infection and trajectories of COVID-19 recovery: Findings from the prospective Predi-COVID cohort study.DOCX

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.

新冠病毒感染后，心理障碍的发生较为普遍。然而，目前针对既往存在的心理障碍是否与新冠病情严重程度及病程进展相关的研究数据仍较为有限。本研究旨在以感染前规律使用精神药物（psychotropic medication, PM）作为情绪或焦虑障碍的替代指标，探讨其与新冠康复轨迹之间的关联。本研究使用Predi-COVID队列研究的数据，纳入新型冠状病毒（SARS-CoV-2）核酸检测呈阳性的成年受试者并开展随访，在入组后14天内收集其人口学特征、临床特征、合并症及每日症状信息。研究人员基于16项症状计算综合症状评分，并构建潜在类别康复轨迹模型；以规律使用精神药物作为主要暴露因素，以不同康复轨迹作为结局变量，开展多项式logistic回归分析。本研究共纳入791名受试者，其中51%为男性，5.3%的受试者报告感染前规律使用精神药物。研究共识别出4种表征康复动态的轨迹类型：「几乎无症状」、「快速康复」、「缓慢康复」以及「症状持续存在」。通过构建针对年龄、性别、社会经济状况、生活方式及合并症的完全校正模型，我们观察到：与「几乎无症状」轨迹相比，规律使用精神药物的受试者处于更严重康复轨迹的风险显著升高——快速康复轨迹的相对风险（95%置信区间）为3.1（2.7, 3.4），缓慢康复轨迹为5.2（3.0, 9.2），症状持续存在轨迹为11.7（6.9, 19.6）。此外，我们还观察到感染前规律使用精神药物与新冠感染后前14天内康复缓慢或无法康复的风险呈梯度关联。本研究结果表明，既往存在的心理异常状态会增加新冠病情进展不良的风险，同时可能提升长新冠（Long COVID）的发生风险。本研究发现可为新冠感染者的个体化诊疗提供参考依据。