COVID-19 infection rates in patients referred for psychiatric admission during a regional surge: The case for universal testing. (April 2021)

• Record Type: Journal Article
• Authors: Brody, Benjamin D.; Shi, Zhenzhen; Shaffer, Charles; Eden, Daniel; Wyka, Katarzyna; Alexopoulos, George S.; Parish, Sharon J.; Kanellopoulos, Dora
• Is Part Of: Psychiatry research. Volume 298(2021)
• Publication Date: 2021-04
• Subjects: COVID-19 testing -- COVID-19 epidemiology -- Psychiatric hospitals -- COVID-19 ethics; Psychiatry -- Periodicals; Psychiatry -- periodicals; Psychiatrie -- Périodiques; 616.89
• DOI: 10.1016/j.psychres.2021.113833
• Languages: English
• ISSNs: 0165-1781

Abstract

Highlights: Some psychiatric facilities have adopted mandatory COVID-19 testing for all inpatients while others have adopted symptom-based or optional testing. We analyzed infection rates in 683 consecutively admitted psychiatric inpatients during the initial surge of COVID-19 in the New York City region. Among these psychiatric inpatients, there was a 9.8% COVID-19 positivity rate. In the majority (76%) of COVID-positive patients, COVID-19 symptoms were not clinically identified. These findings help inform hospital policy regarding COVID-19 testing in psychiatric populations. Abstract: Some psychiatric hospitals have instituted mandatory COVID-19 testing for all patients referred for admission. Others have permitted patients to decline testing. Little is known about the rate of COVID-19 infection in acute psychiatric inpatients. Characterizing the proportion of infected patients who have an asymptomatic presentation will help inform policy regarding universal mandatory versus symptom-based or opt-out testing protocols. We determined the COVID-19 infection rate and frequency of asymptomatic presentation in 683 consecutively admitted patients during the surge in the New York City region between April 3rd, 2020 and June 8th, 2020. Among these psychiatric inpatients, there was a 9.8 % overall rate of COVID-19 infection. Of the COVID-19 infected patients, approximately 76.1 % (51/67) either had no COVID-19 symptoms or could not offer reliable history of symptoms at the time of admission. Had they not been identified by testing and triaged to a COVID-19 positive unit, they could have infected others, leading to institutional outbreak. These findings provide justification for psychiatric facilities to maintain universal mandatory testing policies, at least until community infection rates fall and remain at very low levels.