SARS-CoV-2 susceptibility and COVID-19 illness course and outcome in people with pre-existing neurodegenerative disorders: systematic review with frequentist and Bayesian meta-analyses

Abstract

Background People with neurodegenerative disease and mild cognitive impairment (MCI) may have an elevated risk of acquiring severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and may be disproportionally affected by coronavirus disease 2019 (COVID-19) once infected. Aims To review all eligible studies and quantify the strength of associations between various pre-existing neurodegenerative disorders and both SARS-CoV-2 susceptibility and COVID-19 illness course and outcome. Method Pre-registered systematic review with frequentist and Bayesian meta-analyses. Systematic searches were executed in PubMed, Web of Science and preprint servers. The final search date was 9 January 2023. Odds ratios (ORs) were used as measures of effect. Results In total, 136 primary studies (total sample size n = 97 643 494), reporting on 268 effect-size estimates, met the inclusion criteria. The odds for a positive SARS-CoV-2 test result were increased for people with pre-existing dementia (OR = 1.83, 95% CI 1.16–2.87), Alzheimer's disease (OR = 2.86, 95% CI 1.44–5.66) and Parkinson's disease (OR = 1.65, 95% CI 1.34–2.04). People with pre-existing dementia were more likely to experience a relatively severe COVID-19 course, once infected (OR = 1.43, 95% CI 1.00–2.03). People with pre-existing dementia or Alzheimer's disease were at increased risk for COVID-19-related hospital admission (pooled OR range: 1.60–3.72). Intensive care unit admission rates were relatively low for people with dementia (OR = 0.54, 95% CI 0.40–0.74). All neurodegenerative disorders, including MCI, were at higher risk for COVID-19-related mortality (pooled OR range: 1.56–2.27). Conclusions Our findings confirm that, in general, people with neurodegenerative disease and MCI are at a disproportionally high risk of contracting COVID-19 and have a poor outcome once infected.

SARS-CoV-2 and Parkinson’s Disease: A Review of Where We Are Now

“…A recent systematic review and meta-analysis found that PD patients were at a higher risk of contracting SARS-CoV-2 (OR = 1.65 (1.34–2.04), especially if they were cognitively impaired [ 32 ]. An observational, retrospective, multicenter study ( n = 552) showed that the incidence of COVID-19 was significantly higher among PD patients who were younger than 50 and had shorter durations of disease or had less-advanced PD [ 33 ].…”

“…Five systematic reviews and meta-analyses explored mortality rates among PD patients with COVID-19, concluding that PD may be associated with increased mortality and poor outcomes [ 32 , 35 , 36 , 37 , 67 ]. Although initial estimations varied greatly due to the small number of patients, the study design and the excessive heterogeneity of the collected data, the mortality rate of affected PD patients seems to be somewhere between 18 and 25% [ 31 ].…”

A Comprehensive Review of Neurodegenerative Manifestations of SARS-CoV-2

“…The potential impact of SARS-CoV-2 infection on the development and progression of neurodegenerative disorders is a growing area of concern and interest [ 5 ]. Neurodegeneration, a term encompassing a heterogeneous group of disorders characterized by progressive loss of neuronal structure and function, poses a significant global health challenge [ 6 ]. These disorders rank among the leading causes of disability and mortality worldwide, imposing a substantial burden on healthcare systems and society.…”