COVID-infected psychiatric hospital roommates pose high risk of infection, especially

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A University of Pittsburgh–led study estimates that psychiatric inpatients—especially those on the geriatric unit—with COVID-infected roommates were at much higher risk of infection than those exposed to contagious patients housed elsewhere in the unit from 2020 to 2023.

For the study, published late last week in the American Journal of Infection Control, the researchers compared the risk of SARS-CoV-2 transmission in six units of a US psychiatric hospital among patients with an infectious roommate with that of those with an infectious unit mate from July 2020 to August 2023.

The hospital placed patients with COVID-19 diagnoses in a separate unit that used negative air pressure and required staff to wear N95 respirators. Patients with known SARS-CoV-2 exposure were housed in a separate unit, and new patients were either placed in an individual room or with an unexposed roommate. In all units, physical distancing and universal masking were required until March 2023.

“Patients cared for in psychiatric facilities may have complex psychiatric diagnoses and coexisting medical conditions that are risk factors for severe SARS-CoV-2 infection and complications of infection, and may lack the ability to adhere to masking, social distancing, and other mitigation strategies,” the authors noted. 

Geriatric-unit patients at 6 times the risk

The analysis included 40 and 387 roommate and unit mate exposures, respectively. The COVID-19 infection rate was 10.05% overall, 24.4% for exposed roommates, and 9.3% for exposed unit mates. Average exposure time was 1.84 days.

Cohorting contagious and exposed individuals and avoiding multi-bedded rooms may successfully mitigate COVID-19 transmission risk during psychiatric care.

Patients who shared a room with a contagious roommate were 3.14 more likely than those with an infected unit mate to test positive for COVID-19. Patients exposed to a sick roommate or unit mate in the geriatric psychiatric unit were 6.38 times more likely to become infected. Group therapy wasn’t associated with viral transmission.

“Cohorting contagious and exposed individuals and avoiding multi-bedded rooms may successfully mitigate COVID-19 transmission risk during psychiatric care,” the researchers wrote. “Group therapy may continue to be offered with appropriate mitigation measures due to the minimal contribution to transmission that group therapy offers.”