Alzheimers Res Ther . COVID-19 in adults with dementia: clinical features and risk factors of mortality-a clinical cohort study on 125 patients

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Alzheimers Res Ther


. 2021 Apr 10;13(1):77.
doi: 10.1186/s13195-021-00820-9.
COVID-19 in adults with dementia: clinical features and risk factors of mortality-a clinical cohort study on 125 patients


Agathe Vrillon ^{# 1 2 3} , Elsa Mhanna ^{# 4} , Cl?ment Aveneau ^{5 6} , Manon Lebozec ⁷ , Lina Grosset ^{6 8} , Diane Nankam ⁴ , Fernanda Albuquerque ⁴ , Raphaelle Razou Feroldi ⁴ , Barbara Maakaroun ⁴ , Iana Pissareva ⁴ , Dalenda Cherni Gherissi ⁴ , Julien Azuar ^{5 8 9} , V?ronique Fran?ois ¹⁰ , Claire Hourr?gue ^{6 8} , Julien Dumurgier ^{6 8} , Lisette Volpe-Gillot ⁴ , Claire Paquet ^{5 6}



Affiliations

• PMID: 33838684
• DOI: 10.1186/s13195-021-00820-9

Abstract

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.

Keywords: COVID-19; Dementia; Mortality; Prognostic factors; SARS-CoV-2.