دورية أكاديمية

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

التفاصيل البيبلوغرافية
العنوان: Clinical characteristics and outcomes of COVID-19 patients with preexisting dementia: a large multicenter propensity-matched Brazilian cohort study.
المؤلفون: Bicalho MAC; Medical School, Universidade Federal de Minas Gerais, Av. Professor Alfredo Balena, 190, Sala 246, Santa Efigênia, Belo Horizonte, Brazil. macbicalho@gmail.com.; Cologne University, Albertus-Magnus-Platz, Cologne, 50923, Allemagne. macbicalho@gmail.com., Aliberti MJR; Laboratório de Investigação Médica Em Envelhecimento (LIM-66), Serviço de Geriatria, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.; Research Institute, Hospital Sírio-Libanês, São Paulo, Brazil., Delfino-Pereira P; Medical School, Universidade Federal de Minas Gerais, Av. Professor Alfredo Balena, 190, Sala 246, Santa Efigênia, Belo Horizonte, Brazil.; Institute for Health Technology Assessment (IATS), R. Ramiro Barcelos, 2359, Porto Alegre, Brazil., Chagas VS; Institute for Health Technology Assessment (IATS), R. Ramiro Barcelos, 2359, Porto Alegre, Brazil.; Medical School, Universidade Federal de Viçosa, Av. Peter Henry Rolfs, S/N, Viçosa, Brazil.; Telehealth Center, University Hospital, Universidade Federal de Minas Gerais, Av. Professor Alfredo Balena, 110, Belo Horizonte, Brazil., Rosa PMDS; Medical School, Centro Universitário de Belo Horizonte, Av. Professor Mário Werneck, 1685, Belo Horizonte, Brazil., Pires MC; Department of Statistics, Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627, Belo Horizonte, Brazil., Ramos LEF; Department of Statistics, Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627, Belo Horizonte, Brazil., Bezerra AFB; Hospital das Clínicas da Universidade Federal de Pernambuco, Av. Prof. Moraes Rego, 1235, Recife, Brazil., de Castro Feres AB; Medical School, Faculdade Ciências Médicas de Minas Gerais, Al. Ezequiel Dias, 275, Belo Horizonte, Brazil., Dos Reis Gomes AG; Hospitais da Rede Mater Dei, Av. do Contorno, 9000, Belo Horizonte, Brazil., Bhering AR; Hospital UNIMED BH, Av. do Contorno, 3097, Belo Horizonte, Brazil., Pessoa BP; Hospital Júlia Kubitschek, Av. Professor Alfredo Balena, 190, Belo Horizonte, Brazil., Silva CTCAD; Hospital Santo Antônio, Pç. Dr. Márcio Carvalho Lopes Filho, 501, Curvelo, Brazil., Cimini CCR; Hospital Santa Rosália, R. Do Cruzeiro, 01, Teófilo Otoni, Brazil.; Mucuri Medical School, Universidade Federal dos Vales do Jequitinhonha e Mucuri, R. Cruzeiro, 01, Teófilo Otoni, Brazil., Suemoto CK; Laboratório de Investigação Médica Em Envelhecimento (LIM-66), Serviço de Geriatria, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil., Dias CAC; Medical School, Centro Universitário de Belo Horizonte, Av. Professor Mário Werneck, 1685, Belo Horizonte, Brazil., Carazai DDR; Hospital Nossa Senhora da Conceição and Hospital Cristo Redentor, Av. Francisco Trein, 326, Porto Alegre, Brazil., Ponce D; Botucatu Medical School, Universidade Estadual Paulista 'Júlio de Mesquita Filho', Av. Prof. Mário Rubens Guimarães Montenegro, Botucatu, Brazil., Rios DRA; Universidade Federal de São João del-Rei, R. Sebastião Gonçalves Coelho, 400, Divinópolis, Brazil., Manenti E; Hospital Mãe de Deus, R. José de Alencar, 286, Porto Alegre, Brazil., Anschau F; Hospital Nossa Senhora da Conceição and Hospital Cristo Redentor, Av. Francisco Trein, 326, Porto Alegre, Brazil., Batista JDL; Institute for Health Technology Assessment (IATS), R. Ramiro Barcelos, 2359, Porto Alegre, Brazil.; Universidade Federal da Fronteira Sul, Rod. SC-459, Km 02, Fronteira Sul, Chapecó, Brazil.; Hospital Regional do Oeste, Hospital Regional do Oeste, Florianópolis street, Brazil., Alvarenga JC; Hospital João XXIII, Av. Professor Alfredo Balena, 400, Belo Horizonte, Brazil., Viguini JA; Mucuri Medical School, Universidade Federal dos Vales do Jequitinhonha e Mucuri, R. Cruzeiro, 01, Teófilo Otoni, Brazil., Zanellato JM; Hospital SOS Cárdio, Rod. SC-401, 121, Florianópolis, Brazil., Rugolo JM; Hospital Nossa Senhora da Conceição and Hospital Cristo Redentor, Av. Francisco Trein, 326, Porto Alegre, Brazil., Ruschel KB; Institute for Health Technology Assessment (IATS), R. Ramiro Barcelos, 2359, Porto Alegre, Brazil.; Hospital Universitário Canoas, Av. Farroupilha, 8001, Canoas, Brazil., do Nascimento L; Hospital Universitário de Santa Maria, Av. Roraima, 1000, Santa Maria, Brazil., Menezes LSM; Hospital Metropolitano Odilon Behrens, R. Formiga, 50, Belo Horizonte, Brazil.; Hospital Luxemburgo, R. Gentios, 1350, Belo Horizonte, Brazil., Oliveira LMC; Hospital Universitário Ciências Médicas, R. dos Aimorés, 2896, Belo Horizonte, Brazil., Castro LC; Hospital Bruno Born, Av. Benjamin Constant, 881, Lajeado, Brazil., Nasi LA; Hospital Moinhos de Vento, R. Ramiro Barcelos, 910, Porto Alegre, Brazil., Carneiro M; Hospital Santa Cruz, R. Fernando Abott, 174, Santa Cruz Do Sul, Brazil., Ferreira MAP; Hospital de Clínicas de Porto Alegre, R. Ramiro Barcelos, 2350, Porto Alegre, Brazil., Godoy MF; Hospital São Lucas da PUCRS, Av. Ipiranga, 6690, Porto Alegre, Brazil., Guimarães-Júnior MH; Hospital Márcio Cunha, Av. Kiyoshi Tsunawaki, 48, Ipatinga, Brazil., Oliveira NR; Hospital Eduardo de Menezes, R. Dr. Cristiano Rezende, 2213, Belo Horizonte, Brazil., Ziegelmann PK; Hospital Tacchini, R. Dr. José Mário Mônaco, 358, Bento Gonçalves, Brazil., Porto PF; Medical School, Centro Universitário de Belo Horizonte, Av. Professor Mário Werneck, 1685, Belo Horizonte, Brazil., Mendes PM; Hospitais da Rede Mater Dei, Av. do Contorno, 9000, Belo Horizonte, Brazil., Paraíso PG; Orizonti - Instituto Oncomed de Saúde e Longevidade, Av. José Do Patrocínio Pontes, 1355, Belo Horizonte, Brazil., Reis PPD; Hospital Metropolitano Doutor Célio de Castro, R. Dona Luiza, 311, Belo Horizonte, Brazil., Francisco SC; Hospital Metropolitano Doutor Célio de Castro, R. Dona Luiza, 311, Belo Horizonte, Brazil., Araújo SF; Hospital Semper, Al. Ezequiel Dias, 389, Belo Horizonte, Brazil., Avelino-Silva TJ; Laboratório de Investigação Médica Em Envelhecimento (LIM-66), Serviço de Geriatria, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.; Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, Brazil.; Global Brain Health Institute, University of California, Av, Raja Gabaglia, San Francisco, Estoril, USA., Marcolino MS; Medical School, Universidade Federal de Minas Gerais, Av. Professor Alfredo Balena, 190, Sala 246, Santa Efigênia, Belo Horizonte, Brazil.; Institute for Health Technology Assessment (IATS), R. Ramiro Barcelos, 2359, Porto Alegre, Brazil.; Telehealth Center, University Hospital, Universidade Federal de Minas Gerais, Av. Professor Alfredo Balena, 110, Belo Horizonte, Brazil.
المصدر: BMC geriatrics [BMC Geriatr] 2024 Jan 05; Vol. 24 (1), pp. 25. Date of Electronic Publication: 2024 Jan 05.
نوع المنشور: Observational Study; Multicenter Study; Journal Article; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 100968548 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2318 (Electronic) Linking ISSN: 14712318 NLM ISO Abbreviation: BMC Geriatr Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : BioMed Central, [2001]-
مواضيع طبية MeSH: COVID-19*/complications , COVID-19*/diagnosis , COVID-19*/epidemiology , Sepsis* , Dementia*/diagnosis , Dementia*/epidemiology , Dementia*/therapy, Humans ; Aged ; Brazil/epidemiology ; Cohort Studies ; SARS-CoV-2 ; Inpatients
مستخلص: 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.
(© 2024. The Author(s).)
References: J Biomed Inform. 2009 Apr;42(2):377-81. (PMID: 18929686)
EClinicalMedicine. 2020 Sep;26:100490. (PMID: 32838241)
CMAJ. 2005 Aug 30;173(5):489-95. (PMID: 16129869)
Alzheimers Dement. 2011 May;7(3):257-62. (PMID: 21514247)
Geriatr Gerontol Int. 2021 Feb;21(2):172-177. (PMID: 33340212)
Arq Neuropsiquiatr. 2005 Sep;63(3A):713-9. (PMID: 16172732)
J Am Med Dir Assoc. 2020 Jul;21(7):928-932.e1. (PMID: 32674821)
Alzheimers Dement. 2021 Nov;17(11):1818-1831. (PMID: 33881211)
Int J Infect Dis. 2021 Jun;107:300-310. (PMID: 33444752)
J Biomed Inform. 2019 Jul;95:103208. (PMID: 31078660)
J Am Geriatr Soc. 2022 Jul;70(7):1906-1917. (PMID: 35179781)
Epidemiologia (Basel). 2021 Aug 12;2(3):338-359. (PMID: 36417230)
Int J Surg. 2014 Dec;12(12):1495-9. (PMID: 25046131)
J Am Geriatr Soc. 2021 May;69(5):1116-1127. (PMID: 33818759)
Lancet Psychiatry. 2020 Dec;7(12):1054-1063. (PMID: 33031760)
Crit Care Explor. 2022 Jan 18;4(1):e0616. (PMID: 35072081)
Med Sci (Basel). 2021 Feb 04;9(1):. (PMID: 33557238)
Scott Med J. 2021 May;66(2):89-97. (PMID: 33043852)
Lancet Neurol. 2015 Aug;14(8):823-832. (PMID: 26139023)
Psychiatry Investig. 2021 Jun;18(6):523-529. (PMID: 34218641)
Age Ageing. 2021 Jan 8;50(1):40-48. (PMID: 32986799)
Intern Med J. 2022 May;52(5):724-739. (PMID: 35066970)
Sci Rep. 2017 Nov 16;7(1):15746. (PMID: 29146957)
J Alzheimers Dis. 2020;78(4):1775-1782. (PMID: 33285638)
PLoS One. 2021 Oct 5;16(10):e0258154. (PMID: 34610047)
Lancet. 2020 Apr 11;395(10231):1190-1191. (PMID: 32240625)
Geriatr Nurs. 2021 Sep-Oct;42(5):1230-1239. (PMID: 33824009)
Geriatr Gerontol Int. 2020 Jul;20(7):732-734. (PMID: 32691924)
معلومات مُعتمدة: APQ-01154-21 Fundação de Amparo à Pesquisa do Estado de Minas Gerais; 465518/2014-1 Instituto de Avaliação de Tecnologias em Saúde/Conselho Nacional de Desenvolvimento Científico e Tecnológico; 88887.507149/2020-00 Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
فهرسة مساهمة: Keywords: Brazil; COVID-19; Dementia; Hospital mortality; Hospitalisation; Multicentre study; Prognosis; Retrospective study; Severity
تواريخ الأحداث: Date Created: 20240105 Date Completed: 20240108 Latest Revision: 20240110
رمز التحديث: 20240111
مُعرف محوري في PubMed: PMC10770897
DOI: 10.1186/s12877-023-04494-w
PMID: 38182982
قاعدة البيانات: MEDLINE
الوصف
تدمد:1471-2318
DOI:10.1186/s12877-023-04494-w