Dementia as Risk Factor for Severe Coronavirus Disease 2019: A Case-Control Study

Abstract

BackgroundThe aim of the present study was to investigate the outcome of patients with SARS-CoV-2 infection and dementia.Patients and MethodsIn a multicenter, observational, 1:2 matched case-control study all 23 patients with a history of dementia, hospitalized with a diagnosis of SARS-CoV-2 infection from February 28th 2020 to January 31st 2021 were enrolled. For each Case, 2 patients without dementia observed in the same period study, pair matched for gender, age (±5 years), PaO2/FiO2 (P/F) ratio at admission (<200, or >200), number of comorbidities (±1; excluding dementia) were chosen (Control group).ResultsThe majority of patients were males (60.9% of Cases and Controls) and very elderly [median age 82 years (IQR: 75.5–85) in the Cases and 80 (IQR: 75.5–83.75) in the Controls]. The prevalence of co-pathologies was very high: all the Cases and 43 (93.5%) Controls showed a Charlson comorbidity index of at least 2. During hospitalization the patients in the Case group less frequently had a moderate disease of COVID-19 (35 vs. 67.4%, p = 0.02), more frequently a severe disease (48 vs. 22%, p = 0.03) and more frequently died (48 vs. 22%, p = 0.03). Moreover, during coronavirus disease 2019 (COVID-19), 14 (60.8%) patients in the Case group and 1 (2.1%; p < 0.000) in the Control group showed signs and symptoms of delirium.ConclusionPatients with dementia are vulnerable and have an increased risk of a severe disease and death when infected with COVID-19.

Delirium and Cognitive Impairment as Predisposing Factors of COVID-19 Infection in Neuropsychiatric Patients: A Narrative Review

“…Pisaturo et al [88] reported that patients with a previous diagnosis of dementia were more vulnerable than matched control patients without dementia and at increased risk of severe COVID-19 and consequent death.…”

“…Indeed, preexisting cognitive impairment might also represent a significant predisposing factor for the onset of delirium [92,93] (Table 1). Pisaturo et al [88] reported that patients with dementia are at increased risk of severe COVID-19 and consequent death. Dementia is an insidious neurodegenerative condition, characterized by a chronic and progressive cognitive decline of performance in one or more cognitive domains, interfering with independence in everyday activities.…”

Delirium and Psychiatric Sequelae Associated to SARS-CoV-2 in Asymptomatic Patients With Psychiatric History and Mild Cognitive Impairment as Risk Factors: Three Case Reports

“…Besides risk factors, dementias and COVID-19 might share comorbidities such as hypertension, diabetes, and obesity, most of which are associated with an overactive renin-angiotensin system, cerebrovascular dysfunction and neuroinflammation ( 12 ). The study of Pisaturo et al ( 37 ) reveals that patients with a previous diagnosis of dementia were more vulnerable than matched control patients without dementia, plus at increased risk of severe COVID-19 and consequent death.…”

Prognostic Value of Transaminases and Bilirubin Levels at Admission to Hospital on Disease Progression and Mortality in Patients with COVID-19—An Observational Retrospective Study

“…A wide range of clinical manifestations and outcomes of COVID-19 have been reported, from asymptomatic and mild respiratory infections to pneumonia and acute respiratory distress syndrome (ARDS), as well as life-threatening multiple organ failure [2]. Several studies have highlighted the impact of different risk factors, such as being aged over 65, diabetes, hypertension, chronic kidney disease, dementia, and active cancer, all of which contribute to increased mortality and need for non-invasive and invasive ventilation [3][4][5][6][7]. The identification of clinical and biochemical factors potentially associated with severe COVID-19 is of paramount importance, and may help healthcare professionals to personalize treatment, especially in the current era of early effective treatment, i.e., antivirals and monoclonal antibodies, according to the risk factors of each subject, as well as to allocate proper resources at all levels of care.…”