COVID-19 in Adults With Dementia: Clinical Features and Predictive Factors of Mortality. A Clinical Cohort Study on 125 Patients

Abstract

BACKGROUNDThere is limited evidence on the characteristics and outcome of patients with dementia hospitalized for novel coronavirus infection (COVID-19).METHODWe conducted a prospective study in 2 gerontologic Covid Units in Paris, France, from March 14th 2020 to May 7th 2020. Patients with dementia hospitalized for confirmed COVID-19 infection were systematically enrolled. A binary logistic regression analysis was performed to identify factors associated with mortality at 21 days.RESULTSWe included 125 patients. Median age was 86 (IQI 82-90); 59.4% were female. Most common causes of dementia were Alzheimer’s disease, mixed dementia and vascular dementia. 67.2% had ≥2 comorbidities; 40.2% lived in a long-term care facility. The most common symptoms at COVID-19 onset were confusion and delirium (82.4%), asthenia (76.8%) and fever (72.8%) before polypnea (51.2%) and desaturation (50.4%). Falls were frequent at the initial phase of the disease (35.2%). The fatality rate at 21 days was 22.4%. Chronic kidney disease and CRP at admission were independent factors of death. Persisting confusion, mood and behavioral disorders were observed in survivors (19.2%).CONCLUSIONCOVID-19 in demented individuals is associated with severe outcome in SARS-CoV-2 infection and is characterized by specific clinical features and complications, with confusion and delirium at the forefront. COVID‐19 testing should be considered in front of any significant change from baseline.

COVID-19 Case Fatality and Alzheimer’s Disease

“…Dementia has consistently been identified as a risk factor for death from the novel coronavirus disease 2019 (COVID-19) [1][2][3][4][5][6][7][8]. However, mixed results have been reported regarding whether Alzheimer's disease (AD) is an independent risk factor for COVID-19 mortality, likely due to the relatively small sample size studied [9,10].…”