COVID-19 in patients with severe mental illness: An analysis of in-patients at a psychiatric hospital in Cape Town

Abstract

Background: Psychiatric patients in specialist units are more vulnerable to infections such as SARS-COV-2 (severe acute respiratory syndrome coronavirus 2) because of hospital infrastructure and patients’ mental health. Aim: This study aimed to describe the psychiatric and medical profile, and the risk factors associated with more severe disease and clinical outcomes of coronavirus disease 2019 (COVID-19) in patients with severe mental illness (SMI) admitted to a specialist psychiatric hospital in South Africa between 01 April 2020 and 30 September 2021. Setting: The study was executed at the Vàlkenberg Hospital (VBH), which is a government-funded, specialised psychiatric hospital. The hospital comprises 370 beds made up of 145 forensic service beds and 225 acute service beds. It provides in-patient and out-patient services. Methods: Demographic and clinical information were collected for all VBH in-patients who tested positive for SARS-COV-2 from 01 April 2020 to 30 September 2021. Results: A total of 254 participants tested positive for SARS-COV-2. The sample comprised 75% (n = 191) males with a mean age of 35.7 years. Most patients were diagnosed with schizophrenia (37%, n = 94), bipolar disorder (21%, n = 54) and schizoaffective disorder (19%, n = 49). Reported comorbidities included nicotine use (71%, n = 181), hypertension (11%, n = 28) and human immunodeficiency virus (7%, n = 18). Most patients (62%, n = 156) were symptomatic for COVID-19. Seven per cent (n = 17) required transfer to a medical ward. Almost all patients (99%, n = 252) recovered and 1% (n = 2) died. Conclusion: Contrary to early fears of high mortality among institutionalised SMI patients, most experienced mild COVID-19 illness and recovered. Contribution: This descriptive study provided information on in-patients with COVID-19 disease at a specialised psychiatric hospital during the pandemic.