Journal
ALZHEIMERS RESEARCH & THERAPY
Volume 13, Issue 1, Pages -Publisher
BMC
DOI: 10.1186/s13195-021-00820-9
Keywords
COVID-19; SARS-CoV-2; Dementia; Mortality; Prognostic factors
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In dementia patients, infection with the COVID-19 virus can lead to severe outcomes, characterized by symptoms such as confusion and delirium. The mortality rate at 21 days was 22.4%, with chronic kidney disease and CRP being independent factors of death. Survivors may experience persistent confusion and mood and behavioral disorders.
Background There is limited evidence on the characteristics and outcome of patients with dementia hospitalised for novel coronavirus infection (COVID-19). Method We conducted a prospective study in 2 gerontologic COVID units in Paris, France, from March 14, 2020, to May 7, 2020. Patients with dementia hospitalised for confirmed COVID-19 infection were systematically enrolled. A binary logistic regression analysis was performed to identify factors associated with mortality at 21 days. Results We 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 behavioural disorders were observed in survivors (19.2%). Conclusion COVID-19 in demented individuals is associated with severe outcome in SARS-CoV-2 infection and is characterised 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.
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