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

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art_BICALHO_Clinical_characteristics_and_outcomes_of_COVID19_patients_with_2024.PDF (1.25 MB)
Citações na Scopus
1
Tipo de produção
article
Data de publicação
2024
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
BMC
Autores
BICALHO, Maria Aparecida Camargos
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
Citação
BMC GERIATRICS, v.24, n.1, article ID 25, 11p, 2024
Projetos de Pesquisa
Unidades Organizacionais
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Resumo
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.
Palavras-chave
COVID-19, Dementia, Hospitalisation, Retrospective study, Multicentre study, Prognosis, Severity, Hospital mortality, Brazil
URI
https://observatorio.fm.usp.br/handle/OPI/57836
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MCM
Artigos e Materiais de Revistas Científicas - COVID-19
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - LIM/22
Artigos e Materiais de Revistas Científicas - LIM/66
Artigos e Materiais de Revistas Científicas - ODS/03