COVID‐19 and dementia: Analyses of risk, disparity, and outcomes from electronic health records in the US

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Introduction

At present, there is limited data on the risks, disparity, and outcomes for COVID‐19 in patients with dementia in the United States.

Methods

This is a retrospective case‐control analysis of patient electronic health records (EHRs) of 61.9 million adult and senior patients (age ≥ 18 years) in the United States up to August 21, 2020.

Results

Patients with dementia were at increased risk for COVID‐19 compared to patients without dementia (adjusted odds ratio [AOR]: 2.00 [95% confidence interval (CI), 1.94–2.06], P < .001), with the strongest effect for vascular dementia (AOR: 3.17 [95% CI, 2.97–3.37], P < .001), followed by presenile dementia (AOR: 2.62 [95% CI, 2.28–3.00], P < .001), Alzheimer's disease (AOR: 1.86 [95% CI, 1.77–1.96], P < .001), senile dementia (AOR: 1.99 [95% CI, 1.86–2.13], P < .001) and post‐traumatic dementia (AOR: 1.67 [95% CI, 1.51–1.86] P < .001). Blacks with dementia had higher risk of COVID‐19 than Whites (AOR: 2.86 [95% CI, 2.67–3.06], P < .001). The 6‐month mortality and hospitalization risks in patients with dementia and COVID‐19 were 20.99% and 59.26%, respectively.

Discussion

These findings highlight the need to protect patients with dementia as part of the strategy to control the COVID‐19 pandemic.

Related collections

Most cited references 59

Record: found
Abstract: found
Article: not found

Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

Fei Zhou, Ting Yu, Ronghui Du … (2020)

Summary Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p<0·0001), and d-dimer greater than 1 μg/mL (18·42, 2·64–128·55; p=0·0033) on admission. Median duration of viral shedding was 20·0 days (IQR 17·0–24·0) in survivors, but SARS-CoV-2 was detectable until death in non-survivors. The longest observed duration of viral shedding in survivors was 37 days. Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.

0 comments Cited 13471 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: found

Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area

Safiya Richardson, Jamie Hirsch, Mangala Narasimhan … (2020)

There is limited information describing the presenting characteristics and outcomes of US patients requiring hospitalization for coronavirus disease 2019 (COVID-19).

0 comments Cited 4649 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: found

COVID-19 and African Americans

Clyde Yancy (2020)

0 comments Cited 941 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

Rong Xu: rxx@case.edu

Journal

Journal ID (nlm-ta): Alzheimers Dement

Journal ID (iso-abbrev): Alzheimers Dement

Journal ID (doi): 10.1002/(ISSN)1552-5279

Journal ID (publisher-id): ALZ

Title: Alzheimer's & Dementia

Publisher: John Wiley and Sons Inc. (Hoboken )

ISSN (Print): 1552-5260

ISSN (Electronic): 1552-5279

Publication date (Electronic): 09 February 2021

Electronic Location Identifier: 10.1002/alz.12296

Affiliations

[ ¹ ] Center for Artificial Intelligence in Drug Discovery School of Medicine Case Western Reserve University Cleveland Ohio USA

[ ² ] Center for Clinical Investigation School of Medicine Case Western Reserve University Cleveland Ohio USA

[ ³ ] Tetra Therapeutics Grand Rapids Michigan USA

Author notes

[*] [* ] Correspondence

Rong Xu, Center for Artificial Intelligence in Drug Discovery, School of Medicine, Case Western Reserve University, 2103 Cornell Rd, Cleveland, OH 44106, USA.

E‐mail: rxx@ 123456case.edu

Article

Publisher ID: ALZ12296

DOI: 10.1002/alz.12296

PMC ID: 8014535

PubMed ID: 33559975

SO-VID: 41a9105e-636a-4cc1-9b85-da22cb63a292

License:

This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency.

History

Date revision received : 06 November 2020

Date received : 23 August 2020

Date accepted : 18 December 2020

Page count

Figures: 4, Tables: 1, Pages: 10, Words: 6607

Funding

Funded by: National Institute on Aging , open-funder-registry 10.13039/100000049;

Award ID: AG057557

Award ID: AG061388

Award ID: AG062272

Funded by: National Center for Advancing Translational Sciences , open-funder-registry 10.13039/100006108;

Funded by: Clinical and Translational Science Collaborative (CTSC) of Cleveland

Award ID: UL1TR002548‐01

Custom metadata

source-schema-version-number 2.0

edited-state corrected-proof

details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_JATSPMC version:6.0.1 mode:remove_FC converted:01.04.2021

Keywords: alzheimer's disease,covid‐19,dementia,patient electronic health records

Data availability:

Keywords: alzheimer's disease, covid‐19, dementia, patient electronic health records

COVID‐19 and dementia: Analyses of risk, disparity, and outcomes from electronic health records in the US

Read this article at

Abstract

Introduction

Methods

Results

Discussion

Related collections

Novel Coronavirus Disease COVID-19

Most cited references 59

Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area

COVID-19 and African Americans

Author and article information

Contributors

Journal

Affiliations

Author notes

Article

History

Page count

Funding

Categories

Custom metadata

Comments

Comment on this article

Similar content 267

Cited by 109

Most referenced authors 1,530