At least 38 per cent of older adults in psychiatric wards in London were infected with COVID-19 at the height of the pandemic, and 15 per cent died as a result of the disease, finds a new study in The Lancet Psychiatry.
The retrospective observational study reviewed data from all 344 hospital inpatients of five mental health trusts in London who were either over 65 years or had young-onset dementia, between March and April 2020.
Most (82%) of the patients on the wards were compulsorily detained under the Mental Health Act or Mental Capacity Act, and none had known COVID-19 upon admission.
Of 344 patients, 131 (38%) were diagnosed with COVID-19 during the study period. The mean age of patients who had COVID-19 was 75.3 (standard deviation, 8.2) years; 68 (52%) were women and 47 (36%) were from ethnic minority groups.
A total 16 (12%) of 131 patients were asymptomatic and 121 (92%) had one or more disease-related comorbidity. Just over half (74 patients [56%]) had dementia, of whom 13 (18%) had young-onset dementia.
Of those who fell ill with COVID-19, 35 per cent experienced delirium or acute cognitive decline as a result. A total of 19 (15%) patients diagnosed with COVID-19 died during the study period from the disease.
On average, sites received COVID-19 testing kits 4.5 days after the first clinical COVID-19 presentation.
The researchers have called for increased COVID-19 testing in psychiatric wards, in particular, upon patient admission with isolation until results are known, as well as adequate personal protective equipment provision and close liaison with respiratory physicians.
Lead author Prof Gill Livingston said: “Most of these people had no choice but to be in psychiatric care, so the state has an ethical imperative to protect them. Our findings show that there are unequal standards of care between mental health and physical health wards."
“People shouldn’t be disadvantaged by being in a psychiatric ward.”
