Relationship between Mental Illness and Negative Nucleic Acid Conversion in Patients with COVID-19

Objective: To explore whether mental illness is an independent risk factor affecting nucleic acid conversion in COVID-19 patients. Methods: To retrospectively analyze the clinical data of 149 patients with COVID-19 in Shanghai Public Health Clinical Center, and classify them into the non-psychological disease group (n=134) and the psychological disease group (n=15) according to whether they had a psychological disease at the time of admission and during the hospitalization, and to compare the differences in the indicators of the demographic characteristics of the patients in the two groups, the laboratory parameters on admission, and the clinical outcomes; To evaluate the independent risk factors for nucleic acid conversion events in COVID-19 patients through the Kaplan-Meier curves and multivariate COX regression modeling to assess prognostic factors independently associated with nucleic acid conversion events in COVID-19 patients. Results: Of the 149 newly crowned patients, 15 patients (10.1%) had new-onset psychiatric disorders, and 134 patients (89.9%) had no psychiatric disorders;patients in the mental illness group were older, with more elderly >65 years old (P=0.034), longer time to two nucleic acid conversions (P=0.024), and lower rate of nucleic acid conversion within 14 days (P<0.001).CT1 ORF1ab and E genes were significantly higher in COVID-19 patients with comorbid psychological disorders than in patients in the non-psychological disorders group (P<0.001). However, no significant difference was observed in CT1 N gene (P>0.001).Kaplan-Meier analysis showed that the in-hospital 14-day nucleic acid positivity rate was 60% and 24.6% in the mental illness and non-mental illness groups, respectively (P<0.05). Multivariate regression analysis showed that mental illness and diabetes were independent risk factors for 14-day nucleic acid non-conversion in COVID-19 patients after adjusting for confounders such as age, gender, and co-morbidities. (P<0.001). Conclusion: The prevalence of comorbid psychological disorders in COVID-19 patients is high, and psychological disorders are independent risk factors affecting nucleic acid conversion in COVID-19 patients. Therefore, clinicians should raise awareness of new-onset psychological disorders in COVID-19 patients. Funding: This study was supported by the Youth Program of the National Natural Science Foundation of China (82202423),. Declaration of Interest: The authors declare that they have no conflict of interest. Ethical Approval: Ethical approval was obtained from the Shanghai General Hospital Institutional Review Board [Approval No . [2021]KY037)].