Clinical characteristics and outcomes of COVID-19 patients with preexisting dementia: a large multicenter propensity-matched Brazilian cohort study

被引：5

作者：

Bicalho, Maria Aparecida Camargos ^{[1
,2
]}

Aliberti, Marlon Juliano Romero ^{[3
,4
]}

Delfino-Pereira, Polianna ^{[1
,5
]}

Chagas, Victor Schulthais ^{[5
,6
,7
]}

Rosa, Patryk Marques da Silva ^{[8
]}

Pires, Magda Carvalho ^{[9
]}

Ramos, Lucas Emanuel Ferreira ^{[9
]}

Bezerra, Adriana Falangola Benjamin ^{[10
]}

de Castro Feres, Ana Beatriz ^{[11
]}

dos Reis Gomes, Angelica Gomides ^{[12
]}

Bhering, Angelinda Rezende ^{[13
]}

Pessoa, Bruno Porto ^{[14
]}

Silva, Carla Thais Candida Alves da ^{[15
]}

Cimini, Christiane Correa Rodrigues ^{[16
,17
]}

Suemoto, Claudia Kimie ^{[3
]}

Dias, Cristiana Andrade Coelho ^{[8
]}

Carazai, Daniela dos Reis ^{[18
,19
]}

Ponce, Daniela ^{[20
]}

Rios, Danyelle Romana Alves ^{[21
]}

Manenti, Euler ^{[22
]}

Anschau, Fernando ^{[18
,19
]}

Batista, Joanna d'Arc Lyra ^{[5
,23
,24
]}

Alvarenga, Joice Coutinho de ^{[25
]}

Viguini, Julia Avancini ^{[17
]}

Zanellato, Julia Mariot ^{[26
]}

Rugolo, Juliana Machado ^{[18
,19
]}

Ruschel, Karen Brasil ^{[5
,27
]}

do Nascimento, Leticia ^{[28
]}

Menezes, Luanna Silva Monteiro ^{[29
,30
]}

Oliveira, Lucas Moyses Carvalho de ^{[31
]}

Castro, Luis Cesar de ^{[32
]}

Nasi, Luiz Antonio ^{[33
]}

Carneiro, Marcelo ^{[34
]}

Ferreira, Maria Angelica Pires ^{[35
]}

Godoy, Mariana Frizzo de ^{[36
]}

Guimaraes-Junior, Milton Henriques ^{[37
]}

Oliveira, Neimy Ramos de ^{[38
]}

Ziegelmann, Patricia Klarmann ^{[39
]}

Porto, Paula Fonseca ^{[8
]}

Mendes, Paulo Mascarenhas ^{[12
]}

Paraiso, Pedro Gibson ^{[40
]}

Reis, Priscilla Pereira dos ^{[41
]}

Francisco, Saionara Cristina ^{[41
]}

Araujo, Silvia Ferreira ^{[42
]}

Avelino-Silva, Thiago Junqueira ^{[3
,43
,44
]}

Marcolino, Milena Soriano ^{[1
,5
,7
]}

机构：

[1] Univ Fed Minas Gerais, Sch Med, Ave Prof Alfredo Balena 190,Sala 246, Belo Horizonte, Brazil

[2] Cologne Univ, Albertus Magnus Pl, D-50923 Cologne, Germany

[3] Univ Sao Paulo, Fac Med, Hosp Clin HCFMUSP, Lab Invest Med Envelhecimento LIM 66,Serv Geriatr, Sao Paulo, Brazil

[4] Hosp Sirio Libanes, Res Inst, Sao Paulo, Brazil

[5] Inst Hlth Technol Assessment IATS, R Ramiro Barcelos 2359, Porto Alegre, RS, Brazil

[6] Univ Fed Vicosa, Sch Med, Ave Peter Henry Rolfs S-N, Vicosa, MG, Brazil

[7] Univ Fed Minas Gerais, Univ Hosp, Telehlth Ctr, Ave Prof Alfredo Balena 110, Belo Horizonte, MG, Brazil

[8] Ctr Univ Belo Horizonte, Sch Med, Ave Prof Mario Werneck 1685, Belo Horizonte, MG, Brazil

[9] Univ Fed Minas Gerais, Dept Stat, Ave Presidente Antonio Carlos 6627, Belo Horizonte, MG, Brazil

[10] Univ Fed Pernambuco, Hosp Clin, Ave Prof Moraes Rego 1235, Recife, PE, Brazil

[11] Fac Ciencias Med Minas Gerais, Sch Med, Al Ezequiel Dias 275, Belo Horizonte, Brazil

[12] Hosp Rede Mater Dei, Ave Contorno 9000, Belo Horizonte, Brazil

[13] Hosp UNIMED BH, Ave Contorno 3097, Belo Horizonte, Brazil

[14] Hosp Julia Kubitschek, Ave Prof Alfredo Balena 190, Belo Horizonte, MG, Brazil

[15] Hosp Santo Antonio, Pc Dr Marcio Carvalho Lopes Filho 501, Curvelo, Brazil

[16] Hosp Santa Rosalia, R Cruzeiro 01, Teofilo Otoni, Brazil

[17] Univ Fed Vales Jequitinhonha & Mucuri, Mucuri Med Sch, R Cruzeiro 01, Teofilo Otoni, Brazil

[18] Hosp Nossa Senhora Conceicao, Ave Francisco Trein 326, Porto Alegre, RS, Brazil

[19] Hosp Cristo Redentor, Ave Francisco Trein 326, Porto Alegre, RS, Brazil

[20] Univ Estadual Paulista Julio de Mesquita Filho UN, Botucatu Med Sch, Ave Prof Mario Rubens Guimaraes Montenegro, Botucatu, SP, Brazil

[21] Univ Fed Sao Joao del Rei, R Sebastiao Goncalves Coelho 400, Divinopolis, MG, Brazil

[22] Hosp Mae de Deus, Dept Nucl Med, R Jose de Alencar 286, Porto Alegre, Brazil

[23] Univ Fed Fronteira Sul, Rod SC-459,Km 02, Chapeco, Brazil

[24] Hosp Reg Oeste, Florianopolis St, Chapeco, Brazil

[25] Hosp Joao XXIII, Ave Prof Alfredo Balena 400, Belo Horizonte, Brazil

[26] Hosp SOS Cardio, Rod SC-401,121, Florianopolis, SC, Brazil

[27] Hosp Univ Canoas, Ave Farroupilha 8001, Canoas, RS, Brazil

[28] Hosp Univ Santa Maria, Ave Roraima 1000, Santa Maria, RS, Brazil

[29] Hosp Metropolitano Odilon Behrens, R Formiga 50, Belo Horizonte, Brazil

[30] Hosp Luxemburgo, R Gentios 1350, Belo Horizonte, MG, Brazil

[31] Hosp Univ Ciencias Med, R Aimores 2896, Belo Horizonte, Brazil

[32] Hosp Bruno Born, Ave Benjamin Constant 881, Lajeado, Brazil

[33] Hosp Moinhos Vento, R Ramiro Barcelos 910, Porto Alegre, RS, Brazil

[34] Hosp Santa Cruz, R Fernando Abott 174, Santa Cruz Do Sul, RS, Brazil

[35] Hosp Clin Porto Alegre, R Ramiro Barcelos 2350, Porto Alegre, RS, Brazil

[36] Hosp Sao Lucas PUCRS, Ave Ipiranga 6690, Porto Alegre, RS, Brazil

[37] Hosp Marcio Cunha, Ave Kiyoshi Tsunawaki 48, Ipatinga, Brazil

[38] Hosp Eduardo de Menezes, R Dr Cristiano Rezende 2213, Belo Horizonte, MG, Brazil

[39] Hosp Tacchini, R Dr Jose Mario Monaco 358, Bento Goncalves, RS, Brazil

[40] Orizonti Inst Saude & Longevidade, Ave Jose Do Patrocinio Pontes 1355, Belo Horizonte, Brazil

[41] Hosp Metropolitano Doutor Celio de Castro, R Dona Luiza 311, Belo Horizonte, Brazil

[42] Hosp Semper, Al Ezequiel Dias 389, Belo Horizonte, Brazil

[43] Hosp Israelita Albert Einstein, Fac Israelita Ciencias Saude Albert Einstein, Sao Paulo, Brazil

[44] Univ Calif San Francisco, Global Brain Hlth Inst, Ave Raja Gabaglia, San Francisco, CA USA

来源：

BMC GERIATRICS | 2024年 / 24卷 / 01期

关键词：

COVID-19; Dementia; Hospitalisation; Retrospective study; Multicentre study; Prognosis; Severity; Hospital mortality; Brazil; OLDER-ADULTS; RECOMMENDATIONS; ASSOCIATION; GUIDELINES; MORTALITY; FRAILTY; IMPACT;

D O I：

10.1186/s12877-023-04494-w

中图分类号：

R592 [老年病学]; C [社会科学总论];

学科分类号：

03 ; 0303 ; 100203 ;

摘要：

Background Although dementia has emerged as an important risk factor for severe SARS-CoV-2 infection, results on COVID-19-related complications and mortality are not consistent. We examined the clinical presentations and outcomes of COVID-19 in a multicentre cohort of in-hospital patients, comparing those with and without dementia.Methods This retrospective observational study comprises COVID-19 laboratory-confirmed patients aged >= 60 years admitted to 38 hospitals from 19 cities in Brazil. Data were obtained from electronic hospital records. A propensity score analysis was used to match patients with and without dementia (up to 3:1) according to age, sex, comorbidities, year, and hospital of admission. Our primary outcome was in-hospital mortality. We also assessed admission to the intensive care unit (ICU), invasive mechanical ventilation (IMV), kidney replacement therapy (KRT), sepsis, nosocomial infection, and thromboembolic events.Results Among 1,556 patients included in the study, 405 (4.5%) had a diagnosis of dementia and 1,151 were matched controls. When compared to matched controls, patients with dementia had a lower frequency of dyspnoea, cough, myalgia, headache, ageusia, and anosmia; and higher frequency of fever and delirium. They also had a lower frequency of ICU admission (32.7% vs. 47.1%, p < 0.001) and shorter ICU length of stay (7 vs. 9 days, p < 0.026), and a lower frequency of sepsis (17% vs. 24%, p = 0.005), KRT (6.4% vs. 13%, p < 0.001), and IVM (4.6% vs. 9.8%, p = 0.002). There were no differences in hospital mortality between groups.Conclusion Clinical manifestations of COVID-19 differ between older inpatients with and without dementia. We observed that dementia alone could not explain the higher short-term mortality following severe COVID-19. Therefore, clinicians should consider other risk factors such as acute morbidity severity and baseline frailty when evaluating the prognosis of older adults with dementia hospitalised with COVID-19.

引用

页数：11

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