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      Correlations between COVID-19 and burden of dementia: An ecological study and review of literature

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          Abstract

          Introduction

          Current evidence on the association between COVID-19 and dementia is sparse. This study aims to investigate the associations between COVID-19 caseload and the burden of dementia.

          Methods

          We gathered data regarding burden of dementia (disability-adjusted life years [DALYs] per 100,000), life expectancy, and healthy life expectancy (HALE) from the Global Burden of Disease (GBD) 2017 study. We obtained COVID-19 data from Our World in Data database. We analyzed the association of COVID-19 cases and deaths with the burden and mortality of dementia using Spearman's rank correlation coefficient.

          Results

          Globally, we found significant positive (p < .001) correlations between life expectancy (r = 0.60), HALE (r = 0.58), and dementia DALYs (r = 0.46) with COVID-19 caseloads. Likewise, we found similar correlations between life expectancy (r = 0.60), HALE (r = 0.58) and dementia DALYs (r = 0.54) with COVID-19 mortality.

          Conclusion

          Health policymakers should clarify a targeted model of disease surveillance in order to reduce the dual burden of dementia and COVID-19.

          Highlights

          • We assessed the burden of dementia on COVID-19 caseload and mortality worldwide.

          • Global burden of dementia correlates with COVID-19 caseloads.

          • Global burden of dementia correlates with COVID-19 mortality.

          • Healthy life expectancy correlates with COVID-19 cases and mortality.

          • We recommend a targeted approach to reduce the burden of COVID-19 in dementia.

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          Most cited references37

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          Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention

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            Case-Fatality Rate and Characteristics of Patients Dying in Relation to COVID-19 in Italy

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              Presymptomatic SARS-CoV-2 Infections and Transmission in a Skilled Nursing Facility

              Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can spread rapidly within skilled nursing facilities. After identification of a case of Covid-19 in a skilled nursing facility, we assessed transmission and evaluated the adequacy of symptom-based screening to identify infections in residents. Methods We conducted two serial point-prevalence surveys, 1 week apart, in which assenting residents of the facility underwent nasopharyngeal and oropharyngeal testing for SARS-CoV-2, including real-time reverse-transcriptase polymerase chain reaction (rRT-PCR), viral culture, and sequencing. Symptoms that had been present during the preceding 14 days were recorded. Asymptomatic residents who tested positive were reassessed 7 days later. Residents with SARS-CoV-2 infection were categorized as symptomatic with typical symptoms (fever, cough, or shortness of breath), symptomatic with only atypical symptoms, presymptomatic, or asymptomatic. Results Twenty-three days after the first positive test result in a resident at this skilled nursing facility, 57 of 89 residents (64%) tested positive for SARS-CoV-2. Among 76 residents who participated in point-prevalence surveys, 48 (63%) tested positive. Of these 48 residents, 27 (56%) were asymptomatic at the time of testing; 24 subsequently developed symptoms (median time to onset, 4 days). Samples from these 24 presymptomatic residents had a median rRT-PCR cycle threshold value of 23.1, and viable virus was recovered from 17 residents. As of April 3, of the 57 residents with SARS-CoV-2 infection, 11 had been hospitalized (3 in the intensive care unit) and 15 had died (mortality, 26%). Of the 34 residents whose specimens were sequenced, 27 (79%) had sequences that fit into two clusters with a difference of one nucleotide. Conclusions Rapid and widespread transmission of SARS-CoV-2 was demonstrated in this skilled nursing facility. More than half of residents with positive test results were asymptomatic at the time of testing and most likely contributed to transmission. Infection-control strategies focused solely on symptomatic residents were not sufficient to prevent transmission after SARS-CoV-2 introduction into this facility.
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                Author and article information

                Contributors
                Journal
                J Neurol Sci
                J. Neurol. Sci
                Journal of the Neurological Sciences
                Published by Elsevier B.V.
                0022-510X
                1878-5883
                4 July 2020
                4 July 2020
                : 117013
                Affiliations
                [a ]Stroke Prevention and Atherosclerosis Research Centre, Robarts Research Institute, Western University, London, Ontario, Canada
                [b ]Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada
                [c ]Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
                [d ]Department of Neurology, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
                [e ]Clinical Research Development Unit, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
                [f ]Health Information Science, PhD (candidate) Western University, London, Ontario, Canada
                [g ]Psychiatry and Behavioural Sciences Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
                [h ]Departments of Medicine and Neurology, Melbourne Brain Centre at The Royal Melbourne Hospital, University of Melbourne, Parkville, Australia
                [i ]Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia
                [j ]Department of Neurology, Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA
                [k ]Department of Family Medicine Schulich School of Medicine, Dentistry Western University, London, ON, Canada
                [l ]Research Centre for Prevention of cardiovascular disease, Institute of Endocrinology & Metabolism, Iran University of Medical Sciences, Tehran, Iran
                [m ]Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
                [n ]International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
                [o ]Department of Biostatistics and Epidemiology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
                [p ]Department of Psychiatry, St Joseph's Health Care London, Western University, Canada
                [q ]Department of Neurology and Stroke Unit, San Camillo de’ Lellis General District Hospital, Rieti, Italy
                [r ]Neurological Section, Neuro-epidemiology Unit, SMDN-Centre for Cardiovascular Medicine and Cerebrovascular Disease Prevention, Sulmona, L'Aquila, Italy
                Author notes
                [* ]Correspondence to: N. Mokhber, Department of Psychiatry, St Joseph's Health Care London, Western University, 401 Sunset Dr, N5R 3C6, St Thomas, Ontario, Canada. Naghmeh.Mokhber@ 123456sjhc.london.on.ca
                [** ]Correspondence to: M.D. Napoli, Department of Neurology and Stroke Unit, San Camillo de’ Lellis General District Hospital, Rieti, Italy. mariodinapoli@ 123456katamail.com
                Article
                S0022-510X(20)30350-6 117013
                10.1016/j.jns.2020.117013
                7334961
                32659508
                cf35ddac-3d44-490f-a556-4819ea11f26a
                © 2020 Published by Elsevier B.V.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                : 27 June 2020
                : 1 July 2020
                Categories
                Article

                Neurology
                dementia,covid-19,global burden of disease,mortality,sars-cov, severe acute respiratory syndrome (sars) coronavirus,gbd, global burden of diseases,hale, healthy life expectancy,dalys, disability-adjusted life years,uis, uncertainty intervals,ci, confidence intervals

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