Clinical Presentation of COVID19 in Dementia Patients

Bianchetti, Angelo; Rozzini, Renzo; Guerini, Fabio; Boffelli, Stefano; Ranieri, Piera; Minelli, Giada; Bianchetti, Luca; Trabucchi, Marco

doi:10.1007/s12603-020-1389-1

Cited by 269 publications

(288 citation statements)

References 8 publications

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“…31,32 Renal disease, dementia and cancer could be also important risk factors for severe COVID-19. [33][34][35] The effects of each comorbidity on the COVID-19 mortality have been observed in our results as well, and if they are combined, the effect will be stronger on the severity of COVID-19.…”

Section: Discussionsupporting

confidence: 81%

Impact of comorbidity burden on mortality in patients with COVID-19: a retrospective analysis of the Korean health insurance database

Cho

Yoon

Lee

2020

Preprint

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We aimed to investigate the impact of comorbidity burden on mortality in patients with COVID-19. We analyzed the COVID-19 data from the nationwide health insurance claims of South Korea. Data on demographic characteristics, comorbidities, and mortality records of patients with COVID-19 were extracted from the database. The odds ratios of mortality according to comorbidities in patients with COVID-19 with and without adjustment for age and sex were calculated. The predictive value of the original Charlson comorbidity index (CCI) and the age-adjusted CCI (ACCI) for mortality in patients with COVID-19 were investigated using the receiver operating characteristic (ROC) curve analysis. Among 7,590 patients with COVID-19, 227 (3.0%) had died. After age and sex adjustment, hypertension, diabetes mellitus, congestive heart failure, dementia, chronic pulmonary disease, liver, renal, and cancer were significant risk factors for mortality. The ROC curve analysis showed that ACCI threshold ≥4 yielded the best cut-off point for predicting mortality (area under the ROC 0.92; 95% CI, 0.91–0.94). Our study revealed multiple risk factors that were associated with mortality in patients with COVID-19. The high predictive power of the ACCI for mortality in our results could support the importance of old age and comorbidities in the severity of COVID-19.

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Section: Discussionsupporting

confidence: 81%

Impact of comorbidity burden on mortality in patients with COVID-19: a retrospective analysis of the Korean health insurance database

Cho

Yoon

Lee

2020

Preprint

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“…Apathy occurring in the context of altered consciousness was also described as an atypical presentation of the SARS-CoV-2 infection ( 11 ). This so-called “apathetic delirium” may supersede classical SARS-CoV-2 infection symptoms and interfere with the early identification of COVID-19 disease ( 11 , 19 ).…”

Section: Resultsmentioning

confidence: 99%

“…The rapid spread of COVID-19 and the consequential lack of long-term follow-up studies impede a clear disentanglement of the effects of isolation from other possible, co-occurring influences. As stated above, NPS, and specifically apathy, might represent the most relevant symptom of acute COVID-19 infection ( 11 ). Additionally, SARS-CoV-2 infection has been proposed to directly induce neurodegeneration, even though specific studies investigating such mechanisms in the elderly, and specifically in those with a well-defined diagnosis of dementia, are absent ( 73 ).…”

Section: Limitationsmentioning

confidence: 99%

“…Impaired comprehension of the public health situation and difficulty following restrictive measures has also been reported ( 10 ). More importantly, several authors have described a steep worsening of a plethora of neuropsychiatric symptoms (NPS), including depression, anxiety, anger, agitation, insomnia ( 11 ). These complications may increase levels of distress in caregivers and nursing home staff ( 12 ), favor contagion ( 2 ), and increase risk of self-injury, hospitalization, and death ( 13 ).…”

Section: Introductionmentioning

confidence: 99%

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Neuropsychiatric Symptoms in Elderly With Dementia During COVID-19 Pandemic: Definition, Treatment, and Future Directions

et al. 2020

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Background Neuropsychiatric symptoms (NPS) of dementia, such as anxiety, depression, agitation, and apathy, are complex, stressful, and costly aspects of care, and are associated to poor health outcomes and caregiver burden. A steep worsening of such symptoms has been reported during Coronavirus Disease 2019 (COVID-19) pandemic. However, their causes, their impact on everyday life, and treatment strategies have not been systematically assessed. Therefore, the aim of this review is to provide a detailed description of behavioral and psychopathological alterations in subjects with dementia during COVID-19 pandemic and the associated management challenges. Methods A PubMed search was performed focusing on studies reporting alterations in behavior and mood and treatment strategies for elderly patients with dementia, in accordance with PRISMA guidelines. The following search strategy was utilized: (COVID* OR coronavirus OR “corona vir*” OR SARS-CoV-2) AND (dementia OR demented OR dement* OR alzheimer* OR “pick’s disease” OR “lewy body” OR “mild cognitive” OR mild cognitive impairment OR MCI). Results Apathy, anxiety and agitation are the most frequently NPS during the COVID-19 pandemic and are mainly triggered by protracted isolation. Most treatment strategies rely on pharmacotherapy; technology is increasingly utilized with mixed results. Conclusions NPS of dementia during COVID-19 appear to arise from social restrictions occurring as a consequence of the pandemic. Implementation of caregiver support and the presence of skilled nursing home staff are required to restore social interaction and adjust technological support to the patients’ needs.

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“…A few cohort studies have shown that patients with preexisting neurological disorders who contracted COVID-19 developed more severe clinical symptoms and worse outcomes, compared to the general population [ 4 , 5 ]. In addition, patients with neurological disorders such as Parkinson’s disease and dementia who developed COVID-19 had a worsening of preexisting neurological symptoms [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Exacerbation of neurological symptoms and COVID-19 severity in patients with preexisting neurological disorders and COVID-19: A systematic review

Kubota

Kuroda

2021

Clinical Neurology and Neurosurgery

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Highlights COVID-19 effects were studied in patients with comorbid neurological disorder. This review included 26 reports of comorbid neurological disorder and COVID-19. Papers were identified from the MEDLINE (PubMed) and medRxiv databases. Overall, 22.0 % of patients had severe COVID-19 course. Notably, 31.9 % of patients experienced an exacerbation of preexisting neurological symptoms.

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Clinical Presentation of COVID19 in Dementia Patients

Cited by 269 publications

References 8 publications

Impact of comorbidity burden on mortality in patients with COVID-19: a retrospective analysis of the Korean health insurance database

Impact of comorbidity burden on mortality in patients with COVID-19: a retrospective analysis of the Korean health insurance database

Neuropsychiatric Symptoms in Elderly With Dementia During COVID-19 Pandemic: Definition, Treatment, and Future Directions

Exacerbation of neurological symptoms and COVID-19 severity in patients with preexisting neurological disorders and COVID-19: A systematic review

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