Importance Preexisting noncommunicable diseases (eg, diabetes) increase the risk of COVID-19 infection, hospitalization, and death. Mood disorders are associated with impaired immune function and social determinants that increase the risk of COVID-19. Determining whether preexisting mood disorders represent a risk of COVID-19 would inform public health priorities. Objective To assess whether preexisting mood disorders are associated with a higher risk of COVID-19 susceptibility, hospitalization, severe complications, and death. Data Sources Systematic searches were conducted for studies reporting data on COVID-19 outcomes in populations with and without mood disorders on PubMed/MEDLINE, The Cochrane Library, PsycInfo, Embase, Web of Science, Google/Google Scholar, LitCovid, and select reference lists. The search timeline was from database inception to February 1, 2021. Study Selection Primary research articles that reported quantitative COVID-19 outcome data in persons with mood disorders vs persons without mood disorders of any age, sex, and nationality were selected. Of 1950 articles identified through this search strategy, 21 studies were included in the analysis. Data Extraction and Synthesis The modified Newcastle-Ottawa Scale was used to assess methodological quality and risk of bias of component studies. Reported adjusted odds ratios (ORs) were pooled with unadjusted ORs calculated from summary data to generate 4 random-effects summary ORs, each corresponding to a primary outcome. Main Outcomes and Measures The 4 a priori primary outcomes were COVID-19 susceptibility, COVID-19 hospitalization, COVID-19 severe events, and COVID-19 death. The hypothesis was formulated before study search. Outcome measures between individuals with and without mood disorders were compared. Results This review included 21 studies that involved more than 91 million individuals. Significantly higher odds of COVID-19 hospitalization (OR, 1.31; 95% CI, 1.12-1.53; P = .001; n = 26 554 397) and death (OR, 1.51; 95% CI, 1.34-1.69; P < .001; n = 25 808 660) were found in persons with preexisting mood disorders compared with those without mood disorders. There was no association between mood disorders and COVID-19 susceptibility (OR, 1.27; 95% CI, 0.73-2.19; n = 65 514 469) or severe events (OR, 0.94; 95% CI, 0.87-1.03; n = 83 240). Visual inspection of the composite funnel plot for asymmetry indicated the presence of publication bias; however, the Egger regression intercept test result was not statistically significant. Conclusions and Relevance The results of this systematic review and meta-analysis examining the association between preexisting mood disorders and COVID-19 outcomes suggest that individuals with preexisting mood disorders are at higher risk of COVID-19 hospitalization and death and should be categorized as an at-risk group on the basis of a preexisting condition.

中文翻译：

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情绪障碍与 COVID-19 感染、住院和死亡风险之间的关联：系统评价和荟萃分析。

重要性 先前存在的非传染性疾病（例如糖尿病）会增加 COVID-19 感染、住院和死亡的风险。情绪障碍与免疫功能受损和增加 COVID-19 风险的社会决定因素有关。确定先前存在的情绪障碍是否代表 COVID-19 的风险将为公共卫生优先事项提供信息。目的 评估先前存在的情绪障碍是否与更高的 COVID-19 易感性、住院、严重并发症和死亡风险相关。数据源 对 PubMed/MEDLINE、Cochrane 图书馆、PsycInfo、Embase、Web of Science、Google/Google Scholar、LitCovid 和选择参考列表上的有和无情绪障碍人群的 COVID-19 结果数据的研究进行了系统搜索. 搜索时间线是从数据库开始到 2021 年 2 月 1 日。研究选择主要研究文章报告了任何年龄、性别和国籍的情绪障碍患者与没有情绪障碍的人的定量 COVID-19 结果数据。在通过这种搜索策略确定的 1950 篇文章中，有 21 篇研究被纳入分析。数据提取和综合 修改后的纽卡斯尔-渥太华量表用于评估方法学质量和成分研究的偏倚风险。报告的调整优势比 (OR) 与根据汇总数据计算的未调整 OR 合并，以生成 4 个随机效应汇总 OR，每个 OR 对应于主要结果。主要结果和措施 4 个先验主要结果是 COVID-19 易感性、COVID-19 住院、COVID-19 严重事件、和 COVID-19 死亡。该假设是在研究搜索之前制定的。比较了有和没有情绪障碍的个体之间的结果测量。结果 本综述包括 21 项研究，涉及超过 9100 万人。COVID-19 住院（OR，1.31；95% CI，1.12-1.53​​；P = .001；n = 26 554 397）和死亡（OR，1.51；95% CI，1.34-1.69；P < . 001；n = 25 808 660）与没有情绪障碍的人相比，在患有先前存在的情绪障碍的人中发现。情绪障碍与 COVID-19 易感性（OR，1.27；95% CI，0.73-2.19；n = 65 514 469）或严重事件（OR，0.94；95% CI，0.87-1.03；n = 83）之间没有关联240)。对不对称复合漏斗图的目视检查表明存在发表偏倚；然而，Egger 回归截距检验结果无统计学意义。结-基于预先存在的条件的风险组。