Risk factors of COVID-19 in subjects with and without mental disorders

BACKGROUND: Subjects with mental disorders are at a higher risk of various pandemic, but no specific studies concerning on screening and comparing the risk factors of COVID-19 for subjects with and without mental disorders, and the role of different classes of mental disorders with respect to the COVID-19. METHODS: This study comprised 42,264 subjects with mental disorders and 431,694 subjects without. Logistic regression was used to evaluate the associations of exposure factors with COVID-19 risk. Interaction terms were employed to explore the potential interaction effect between mental disorders and each exposure factor on COVID-19 risk. RESULTS: Mental disorders increased 1.45-fold risk of COVID-19 compared with non-mental disorders. There were significant interaction effects between mental disorders and age, sex, ethnicity, health ratings, socioeconomic adversity, lifestyle habits or comorbidities on COVID-19 risk. Subjects with and without mental disorders shared some overlapping risk factors of COVID-19, including the non-white ethnicity, socioeconomic adversity and comorbidities. Subjects without mental disorders carry some specific risk and protective factors. Among subjects with mental disorders, the COVID-19 risk was higher in subjects with a diagnosis of organic/symptomatic mental disorders, mood disorders, and neurotic, stress-related and somatoform disorders than that of their counterparts. Age, amount of alcohol consumption, BMI and Townsend deprivation showed non-linear increase with COVID-19 risk. LIMITATIONS: Absence of replication. CONCLUSIONS: Subjects with mental disorders are vulnerable populations to whom more attention should be paid. Public health guidance should focus on reducing the COVID-19 risk by advocating healthy lifestyle habits and preferential policies in populations with comorbidities.