Mortality Rates According to the Time of Onset of Mental Disorders Among Patients With Coronavirus Disease 2019 in South Korea: A Nationwide Retrospective Study

Objective This study aimed to investigate the association between the timing of mental disorder diagnosis and all-cause mortality among patients with coronavirus disease 2019 (COVID-19) during the initial period of the pandemic.Methods This retrospective study used the K-COV-N cohort (Korea Disease Control and Prevention Agency–COVID-19–National Health Insurance Service cohort). Patients with confirmed COVID-19 between October 2020 and December 2021 were classified into three groups: those without mental disorders, those with pre-existing mental disorders, and those with newly diagnosed mental disorders during the COVID-19 pandemic. Logistic regression analysis was performed to estimate the association between mental disorder group and all-cause mortality.Results A total of 432,852 patients with COVID-19 were included in the analysis. Of these, 351,519 (81.21%) had no mental disorders, 54,846 (12.67%) had pre-existing mental disorders, and 26,487 (6.12%) had newly diagnosed mental disorders during the pandemic. The overall all-cause mortality rate was 0.72% (n=3,099). Compared with patients without mental disorders, those with pre-existing mental disorders (adjusted odds ratio [aOR], 1.33; 95% confidence interval [CI], 1.21–1.47) and those with newly diagnosed mental disorders (aOR, 1.63; 95% CI, 1.44–1.84) had higher odds of all-cause mortality.Conclusion Among patients with COVID-19, both pre-existing and newly diagnosed mental disorders were associated with increased all-cause mortality, with a stronger association observed for newly diagnosed mental disorders.