Infectious Disease

Dementia is an unbiased danger issue for COVID-19 an infection

February 09, 2021

4 min read

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Patients with dementia, particularly those with vascular dementia, were at increased risk for COVID-19 according to the results published in Alzheimer Disease & Dementia.

The researchers also found that black patients with dementia were at higher risk for COVID-19 than white patients.

‚ÄúCardiovascular disease, diabetes, obesity and high blood pressure are major risk factors for cognitive decline and dementia. Many of these common comorbidities in patients with dementia are also risk factors for COVID-19 and have been linked to poorer clinical outcomes. ” Quangqiu Wang, An artificial intelligence specialist at the Center for Artificial Intelligence in Drug Discovery at Case Western Reserve University Medical School and colleagues wrote. “In addition, the memory disorder associated with dementia can affect the patient’s ability to follow preventive measures against COVID-19 such as social distancing, wearing masks and frequent hand sanitizing.”

In addition, previous results from other researchers showed that the altered blood-brain barrier in patients with Alzheimer’s disease “predisposes them to viral and bacterial infections.” Pamela B. Davis, MD, PhD, Dean of the Medical School of Case Western Reserve University, Arline H. and Curtis F. Garvin Research Professors and Professor in the Department of Pediatrics in the Medical School of Case Western Reserve University, and Rong Xu, PhD, Professor of biomedical informatics and director of the Center for Artificial Intelligence in Drug Discovery at Case Western Reserve University’s medical school, told Healio Neurology. As a result, they hypothesized that “the altered blood-brain barrier in these people may also lead to an increased risk of SARS-CoV-2 virus infection,” said Davis and Xu.

Researchers conducted a retrospective case-control review of the electronic health records of 61.9 million adult and elderly patients 18 years and older in the United States by August 21, 2020. They pulled EHR data from 360 hospitals and 317,000 providers in 50 states, which the study found made up 20% of the US population.

Wang and colleagues analyzed the association between dementia and risk for COVID-19, taking into account age, gender, race, comorbidities, transplant history, and nursing home stays. The researchers performed a separate analysis for each of the five types of dementia and examined the different effects of demographic factors on the risk of COVID-19. Outcome measures included COVID-19 diagnosis, hospitalization, and death.

The total study population of 61.9 million included more than 1 million patients with dementia. Specific types of dementia included AD (0.57%), post-traumatic dementia (0.2%), presenile dementia (0.05%), senile dementia (0.28%), and vascular dementia (0.19%).

The group of 15,770 adult and elderly patients diagnosed with COVID-19 included 810 patients with dementia (5.14% of the COVID-19 population), including 260 patients with AD (1.65% of the COVID-19 population) Population), 70 patients with post-traumatic dementia (0.44%), 40 with presenile dementia (0.25%), 140 with senile dementia (0.89%) and 170 with vascular dementia (1.08%).

Patients with dementia had an increased risk of COVID-19 compared to patients without dementia [aOR] = 2; 95% CI, 1.94-2.06), with the strongest effect being demonstrated in vascular dementia (aOR = 3.17; 95% CI, 2.97-3.37), followed by presenile dementia (aOR = 2 , 62; 95% CI, 2.28-3), AD (aOR = 1.86; 95% CI, 1.77-1.96), senile dementia (aOR = 1.99; 95% CI, 1, 86-2.13) and post-traumatic dementia (aOR = 1.67; 95% CI, 1.51-1.86).

Rong Xu

Rong Xu “Our article shows a highly significant two-fold increase in COVID-19 infections in patients with dementia, even after considering known COVID-19 risk factors,” said Davis and Xu. “There is less than one in 1,000 chances that this result was achieved by accident alone.”

Black patients with dementia showed an increased likelihood of COVID-19 infection compared to white patients with dementia, even after considering age, gender, and COVID-19 risk factors (aOR = 2.86; 95% CI, 2.67- 3.06). The researchers observed similar racial differences in AD and in vascular dementia.

The overall risk of hospitalization for all patients diagnosed with COVID-19 was 25.17% according to study results. More than half of the patients with dementia diagnosed with COVID-19 (59.26%) were hospitalized, with the rate being higher in black patients (73.08%) than in white patients (53.85 %; P <0.01). For comparison: 14,960 adult and elderly patients with COVID-19, but without dementia, were hospitalized in the 6 months studied (23.26%), the rate being higher in black patients (31.99%) than in white patients (18.57%; P <). 001).

Adult and elderly patients diagnosed with COVID-19 had a 6-month mortality risk of 5.64%, according to Wang and colleagues’ findings. Among the patients with dementia and COVID-19, 170 (20.99%) died, with rates similar between black patients (23.08%) and white patients (19.23%).

“As found in many studies of susceptibility to COVID-19 infection, our study found that black patients were two to three times the risk of COVID-19 compared to white patients,” said Davis and Xu. “Once infected, they have a similar risk of hospitalization and death.”

In addition to specific racial differences, the results of the present study also highlighted the susceptibility of patients with dementia to COVID-19.

“Known comorbidities for COVID-19 are certainly part of the susceptibility of dementia patients to COVID-19, but even after considering these factors (such as dormitory, age, high blood pressure, diabetes, and others), dementia was independently a risk factor for infection,” said Davis and Xu . “This vulnerability, along with observations by others that patients with dementia greatly benefit from human contact, would suggest that priority should be given to vaccinating patients with dementia and their carers.”

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