1 Montreal Geriatrics Institute Research Centre, Montreal.
2 Department of Family and Emergency Medicine, University of Montreal, Montreal.
3 Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montreal.
4 Douglas Research Center, Montreal.
5 Research Institute of the McGill University Health Centre, Montreal.
6 Department of Pharmacology and Physiology, University of Montreal, Montreal.
7 Infectious Diseases and Immunity in Global Health Program, Montreal.
8 Division of Infectious Diseases, Department of Medicine, McGill University Health Centre, Montréal.
9 Department of Psychology, Concordia University, Montreal, QC.

Background: SARS-CoV-2 infection can lead to persistent post-acute neuropsychiatric symptoms. Older adults with multimorbidity may be at increased risk of post-acute symptoms after COVID-19. The goals of the present study were to assess the associations of SARS-CoV-2 infection with neuropsychiatric symptoms and psychotropic medication prescription among older adults living in long-term care facilities.

Methods: Nursing home residents (n=111) participated in this three-month longitudinal study. Nurse ratings of neuropsychiatric symptoms were conducted at baseline and at the three-month follow-up. SARS-CoV-2 infection status and psychotropic medication prescription were extracted from a medical chart review.

Results: About 73.9% of participants were infected with SARS-CoV-2 on average 480.49 (SD= 228) days before study enrollment. There were no significant changes in neuropsychiatric symptoms during the study follow-up period. Participants with a SARS-CoV-2 infection had more agitation compared to those who were never infected. However, this effect disappeared after adjusting for age, sex, history of psychiatric disorder, neurocognitive status, and multimorbidity. Participants with SARS-CoV-2 had a higher number of psychotropic medication prescription. This effect was driven by increased use of antidepressants and antipsychotic medications.

Conclusion: Both acute and short-term neuropsychiatric symptoms associated with COVID-19 may contribute to long-term psychoactive polypharmacy among older adults living in long-term facilities.