Wang Sheng-Min, Park See Hyun, Kim Nak-Young, Kang Dong Woo, Na Hae-Ran, Um Yoo Hyun, Han Seunghoon, Park Sung-Soo, Lim Hyun Kook
Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Department of Pharmacology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Psychiatry Investig. 2021 Jun;18(6):523-529. doi: 10.30773/pi.2021.0064. Epub 2021 Jun 24.
Despite a high prevalence of dementia in older adults hospitalized with severe acute respiratory syndrome coronavirus 2 infection (SARS-CoV-2), or so called COVID-19, research investigating association between preexisting diagnoses of dementia and prognosis of COVID-19 is scarce. We aimed to investigate treatment outcome of patients with dementia after COVID-19.
We explored a nationwide cohort with a total of 2,800 subjects older than 50 years who were diagnosed with COVID-19 between January and April 2020. Among them, 223 patients had underlying dementia (dementia group). We matched 1:1 for each dementia- non-dementia group pair yielding 223 patients without dementia (no dementia group) using propensity score matching.
Mortality rate after COVID-19 was higher in dementia group than in no dementia group (33.6% vs. 20.2%, p=0.002). Dementia group had higher proportion of patients requiring invasive ventilatory support than no dementia group (34.1% vs. 22.0%, p=0.006). Multivariable analysis showed that dementia group had a higher risk of mortality than no dementia group (odds ratio=3.05, p<0.001). We also found that patients in dementia group had a higher risk of needing invasive ventilatory support than those in no dementia group.
Our results suggest that system including strengthen quarantines are required for patients with dementia during the COVID- 19 pandemic.
尽管在因严重急性呼吸综合征冠状病毒2感染（SARS-CoV-2）住院的老年人中，即所谓的2019冠状病毒病（COVID-19）患者中痴呆症的患病率很高，但研究痴呆症的既往诊断与COVID-19预后之间关联的研究却很少。我们旨在研究COVID-19后痴呆症患者的治疗结果。
我们在全国范围内进行了一项队列研究，共有2800名50岁以上的受试者，他们在2020年1月至4月期间被诊断为COVID-19。其中，223名患者患有潜在痴呆症（痴呆症组）。我们使用倾向评分匹配，为每个痴呆症-非痴呆症组对进行1:1匹配，产生了223名无痴呆症患者（无痴呆症组）。
COVID-19后的死亡率在痴呆症组高于无痴呆症组（33.6%对20.2%，p=0.002）。痴呆症组需要有创通气支持的患者比例高于无痴呆症组（34.1%对22.0%，p=0.006）。多变量分析显示，痴呆症组的死亡风险高于无痴呆症组（优势比=3.05，p<0.001）。我们还发现，痴呆症组的患者比无痴呆症组的患者需要有创通气支持的风险更高。
我们的结果表明，在COVID-19大流行期间，需要为痴呆症患者建立包括加强隔离在内的系统。
