# COVID-19 in patients with severe mental illness: An analysis of in-patients at a psychiatric hospital in Cape Town

## TL;DR

This study analyzed how patients with severe mental illness in a psychiatric hospital in Cape Town experienced and recovered from COVID-19.

## Contribution

The study provides descriptive insights into the clinical outcomes of psychiatric in-patients with SARS-COV-2 during the pandemic.

## Key findings

- Most patients (99%) with SARS-COV-2 recovered, with only 1% dying.
- The majority of patients experienced mild symptoms, contrary to initial fears of high mortality.
- Common mental illnesses included schizophrenia, bipolar disorder, and schizoaffective disorder.

## Abstract

Psychiatric patients in specialist units are more vulnerable to infections such as SARS-COV-2 (severe acute respiratory syndrome coronavirus 2) because of hospital infrastructure and patients’ mental health.

This study aimed to describe the psychiatric and medical profile, and the risk factors associated with more severe disease and clinical outcomes of coronavirus disease 2019 (COVID-19) in patients with severe mental illness (SMI) admitted to a specialist psychiatric hospital in South Africa between 01 April 2020 and 30 September 2021.

The study was executed at the Vàlkenberg Hospital (VBH), which is a government-funded, specialised psychiatric hospital. The hospital comprises 370 beds made up of 145 forensic service beds and 225 acute service beds. It provides in-patient and out-patient services.

Demographic and clinical information were collected for all VBH in-patients who tested positive for SARS-COV-2 from 01 April 2020 to 30 September 2021.

A total of 254 participants tested positive for SARS-COV-2. The sample comprised 75% (n = 191) males with a mean age of 35.7 years. Most patients were diagnosed with schizophrenia (37%, n = 94), bipolar disorder (21%, n = 54) and schizoaffective disorder (19%, n = 49). Reported comorbidities included nicotine use (71%, n = 181), hypertension (11%, n = 28) and human immunodeficiency virus (7%, n = 18). Most patients (62%, n = 156) were symptomatic for COVID-19. Seven per cent (n = 17) required transfer to a medical ward. Almost all patients (99%, n = 252) recovered and 1% (n = 2) died.

Contrary to early fears of high mortality among institutionalised SMI patients, most experienced mild COVID-19 illness and recovered.

This descriptive study provided information on in-patients with COVID-19 disease at a specialised psychiatric hospital during the pandemic.