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

Alzheimers Res Ther. 2021 Apr 10;13(1):77. 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.

Publication types

  • Multicenter Study

MeSH terms

  • Aged, 80 and over
  • COVID-19 / complications
  • COVID-19 / mortality*
  • COVID-19 Testing
  • Comorbidity
  • Dementia* / complications
  • Dementia* / virology
  • Female
  • France / epidemiology
  • Humans
  • Male
  • Prospective Studies
  • Risk Factors