MARLON JULIANO ROMERO ALIBERTI

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Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/66, Hospital das Clínicas, Faculdade de Medicina

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  • article 1 Citação(ões) na Scopus
    Clinical characteristics and outcomes of COVID-19 patients with preexisting dementia: a large multicenter propensity-matched Brazilian cohort study
    (2024) BICALHO, Maria Aparecida Camargos; ALIBERTI, Marlon Juliano Romero; DELFINO-PEREIRA, Polianna; CHAGAS, Victor Schulthais; ROSA, Patryk Marques da Silva; PIRES, Magda Carvalho; RAMOS, Lucas Emanuel Ferreira; BEZERRA, Adriana Falangola Benjamin; FERES, Ana Beatriz de Castro; GOMES, Angelica Gomides dos Reis; BHERING, Angelinda Rezende; PESSOA, Bruno Porto; SILVA, Carla Thais Candida Alves da; CIMINI, Christiane Correa Rodrigues; SUEMOTO, Claudia Kimie; DIAS, Cristiana Andrade Coelho; CARAZAI, Daniela dos Reis; PONCE, Daniela; RIOS, Danyelle Romana Alves; MANENTI, Euler; ANSCHAU, Fernando; BATISTA, Joanna d'Arc Lyra; ALVARENGA, Joice Coutinho de; VIGUINI, Julia Avancini; ZANELLATO, Julia Mariot; RUGOLO, Juliana Machado; RUSCHEL, Karen Brasil; NASCIMENTO, Leticia do; MENEZES, Luanna Silva Monteiro; OLIVEIRA, Lucas Moyses Carvalho de; CASTRO, Luis Cesar de; NASI, Luiz Antonio; CARNEIRO, Marcelo; FERREIRA, Maria Angelica Pires; GODOY, Mariana Frizzo de; GUIMARAES-JUNIOR, Milton Henriques; OLIVEIRA, Neimy Ramos de; ZIEGELMANN, Patricia Klarmann; PORTO, Paula Fonseca; MENDES, Paulo Mascarenhas; PARAISO, Pedro Gibson; REIS, Priscilla Pereira dos; FRANCISCO, Saionara Cristina; ARAUJO, Silvia Ferreira; AVELINO-SILVA, Thiago Junqueira; MARCOLINO, Milena Soriano
    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.