- Title
- COVID-19 in Psychiatric Inpatients: A South African Descriptive Study Conducted at Fort England
- Creator
- Gwanya-Mdletye, Sisikelelwe Sylvia
- Date Issued
- 2023-11
- Date
- 2023-11
- Type
- Masters theses
- Type
- text
- Identifier
- http://hdl.handle.net/11260/12977
- Identifier
- vital:76184
- Description
- Psychiatric patients are known to have an increased risk of adverse outcomes from COVID-19. Some psychiatric medications are known to have cardiometabolic and immune system-related side effects and have been found to either protect from or worsen outcomes in COVID-19 illness. The interaction of COVID-19 with the cardiometabolic and immune-related aspects of psychiatric illness and treatment has not been sufficiently studied in people with mental illness. Aim: To describe the clinical and demographic characteristics, and clinical outcomes of adult inpatients at Fort England Psychiatric Hospital who contracted SARS-CoV-2 during the first wave of the COVID-19 pandemic, including statistical and case analyses of COVID-19 related deaths. Methods: The study was conducted at Fort England Hospital (FEH). Data were obtained from patient files, treatment charts, and the hospital's COVID-19 reporting schedules. Sixty-four patients were diagnosed with COVID-19 during the first wave of infections in the hospital, and five of them died. A cross-sectional research design was adopted, in which the COVID-19 outcomes of the 64 patients were described alongside their psychiatric disease and treatment factors. Descriptive statistics were used to describe the characteristics of the participants. Fisher’s exact test for contingency tables and Cramér's V effect size were computed to identify possible associations between death and specified clinical variables. Additionally, case analyses were carried out on each patient who died based on participant case notes. Results: The incidence of SARS-CoV-2 infections was 21.8% during the first wave of infections, and the case fatality rate was 7.8%. A significant association was ii found between higher age and COVID-19 related death (Fisher’s exact test p = 0.010). Two-thirds (68%) of the patients who recovered were younger than 45, whereas one of the five patients who died (20%) fell in this age group. Race was also strongly related to COVID-19 outcomes, with coloured comprising 80% of the participants who died compared to 80% of black African patients in the recovered group (Fisher’s exact test p = 0.012). All patients who died had co-morbid medical conditions compared to 58% of those who recovered, although this relationship was weak (Fisher’s exact 1-sided test p = 0.076). However, case analyses for the patients who died revealed recurring themes of multiple psychiatric comorbidities, proneness to psychotropic treatment side effects, and a history of frequent relapses among most of these patients. All who died were faced with adversity and dire life circumstances. Conclusions: This study contributes to a better understanding of clinical, demographic and social variables that impacts COVID-19 outcomes in an in-patient psychiatric population. first wave of the COVID-19 pandemic in patients with serious mental illness in an inpatient population. More studies of a larger scale are needed to describe the COVID-19 pandemic among psychiatric populations and to investigate factors that contribute to the vulnerability of psychiatric patients to adverse outcomes of COVID-19.
- Description
- Thesis (Masters) -- Faculty of Medicine and Health Sciences, 2023
- Format
- computer
- Format
- online resource
- Format
- application/pdf
- Format
- 1 online resource (75 pages)
- Format
- Publisher
- Walter Sisulu University
- Publisher
- Faculty of Medicine and Health Sciences
- Language
- English
- Rights
- Faculty of Medicine and Health Sciences
- Rights
- All Rights Reserved
- Rights
- Open Access
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