Background: Severe mental illnesses are associated with an increased risk of COVID-19-related mortality. Research on COVID-19 among nursing home residents with severe mental illnesses, or ‘double care demanding patients’, is lacking. Ideally, these patients reside in specialized gerontopsychiatric wards within mental health and nursing home facilities, such as a ‘psychiatric nursing home’.
Aim: To explore differences in mortality after COVID-19 between residents of a ‘psychiatric nursing home’ (PNH) and residents of general nursing homes (GNH) following first vaccination.
Method: 54 PNH residents and 169 GNH residents with COVID-19 shortly (<4 weeks) after the first vaccination were included. Mortality was analyzed using Cox regression analysis.
Results: PNH residents were significantly younger (84.1 vs. 72.5 years) and had significantly more often ≥1 mental illness than GNH residents (p>0.001). Risk of mortality after 30 days was lower for PNH residents after 30 days (HR: 0.49; 95%-CI: 0.22-1.09) and 180 days (HR: 0.45; 95%-CI: 0.22-0.91). Adjusted for confounders, no significant differences in mortality risk were found after 30 days (HR: 0.74; 95%-CI: 0.27-2.03) and 180 days (HR: 0.76; 95%-CI: 0.31-1.85).
Conclusion: Although severe mental illnesses are associated with an increased risk of COVID-19-related mortality outside nursing homes, we could not find a significant difference in 30-day and 180-day mortality after SARS-CoV-2-infection between PNH residents and GNH residents following the first COVID-19 vaccination. We encourage further research to explore health outcomes of ‘double care demanding patients’, with specific attention to the impact of integrated care.
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Background: Severe mental illnesses are associated with an increased risk of COVID-19-related mortality. Research on COVID-19 among nursing home residents with severe mental illnesses, or ‘double care demanding patients’, is lacking. Ideally, these patients reside in specialized gerontopsychiatric wards within mental health and nursing home facilities, such as a ‘psychiatric nursing home’.
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Paroxysmal nocturnal hemoglobinuria (PNH) is a rare acquired disease characterized by clonal hematopoietic stem cell disorder, with increased mortality and morbidity. Venous thrombosis is the most common cause of mortality in PNH. The relationship between PNH and cerebrovascular disease is unclear; few cases are reported in the literature, most of them related to cerebral venous thrombosis; In PNH the involvement of intracranial and extracranial arterial sites is very rare.
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