The Association of Pre-existing Diagnoses of Alzheimer's Disease and Parkinson's Disease and Coronavirus Disease 2019 Infection, Severity and Mortality: Results From the Korean National Health Insurance Database

Ji Hee Kim; In Bok Chang; Yoo Hwan Kim; Chan Yang Min; Dae Myoung Yoo; Hyo Geun Choi

doi:10.3389/fnagi.2022.821235

The Association of Pre-existing Diagnoses of Alzheimer's Disease and Parkinson's Disease and Coronavirus Disease 2019 Infection, Severity and Mortality: Results From the Korean National Health Insurance Database

Front Aging Neurosci. 2022 Mar 3:14:821235. doi: 10.3389/fnagi.2022.821235. eCollection 2022.

Authors

Ji Hee Kim¹, In Bok Chang¹, Yoo Hwan Kim², Chan Yang Min³, Dae Myoung Yoo³, Hyo Geun Choi^{3

4}

Affiliations

¹ Department of Neurosurgery, Hallym University College of Medicine, Anyang, South Korea.
² Department of Neurology, Hallym University College of Medicine, Anyang, South Korea.
³ Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, South Korea.
⁴ Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Anyang, South Korea.

Abstract

Objectives: Despite the numerous studies on coronavirus disease 2019 (COVID-19), data regarding the impact of pre-existing diagnoses of Alzheimer's disease (AD) and Parkinson's disease (PD) on the susceptibility to and outcome of COVID-19 are limited. We aimed to determine whether patients with AD/PD had a higher likelihood of contracting COVID-19 and experiencing worse outcomes.

Methods: Data from patients with confirmed diagnoses of COVID-19 (n = 8,070) from January to June 2020 and control participants (n = 121,050) who were randomly selected to match the patients on the basis of age and sex were extracted from the Korean National Health Insurance Database. Pre-existing diagnoses of AD and PD were identified based on medical claim codes. The associations of pre-existing AD or PD with contracting COVID-19, developing severe COVID-19 and dying due to COVID-19 were examined using a logistic regression model. The participants' age, sex, income, comorbidity score, and history of hypertension/diabetes were assessed as covariates.

Results: COVID-19 cases were more likely to have a pre-existing AD diagnosis (adjusted odds ratio [aOR] = 2.11, 95% confidence interval [CI] = 1.79-2.50, P-value < 0.001) than controls. COVID-19 cases were more likely to have a pre-existing PD diagnosis than controls, although this estimate did not quite reach statistical significance (aOR = 1.41, 95% CI = 1.00-2.00, P-value = 0.054). Pre-existing AD was related to severe disease and mortality from COVID-19 (aOR = 2.21, 95% CI = 1.64-2.98; aOR = 2.21, 95% CI = 1.00-2.00). Pre-existing PD was not associated with mortality (aOR = 1.54, 95% CI = 0.75-3.16) but was associated with severe disease (aOR = 2.89, 95% CI = 1.56-5.35).

Conclusion: We found that COVID-19 infection was significantly associated with a pre-existing diagnosis of AD but not with a pre-existing diagnosis of PD. Patients with pre-existing AD had higher odds of developing severe COVID-19 and dying. Pre-existing PD was only associated with a higher odds of developing severe COVID-19.

Keywords: Alzheimer’s disease; Coronavirus disease 2019 (COVID-19); Parkinson’s disease; dementia; neurodegeneration; neurodegenerative disease.