Institute of Convergence Medicine, Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea.
Advanced Biomedical Research Institute, Ewha Womans University Seoul Hospital, Seoul, Republic of Korea.
Dement Geriatr Cogn Disord. 2021;50(5):425-436. doi: 10.1159/000519466. Epub 2021 Dec 2.
The study evaluated the increased mortality risk within 14 days of coronavirus disease 2019 (COVID-19) diagnosis in dementia patients.
This retrospective study was conducted from February to April 2020 using the COVID-19 patients' database from the Korea Disease Control and Prevention Agency. The risk factors for early death within 14 days were determined using generalized logistic regression performed in a stepwise manner. Dementia patients diagnosed with COVID-19 were used for the study. The propensity score-matched cohort was included as controls. The differences in mortality within 14 days after COVID-19 diagnosis between the dementia patients and controls were evaluated.
We enrolled 5,349 COVID-19 patients from the database; 224 had dementia as comorbidity. The mortality rate within 14 days after COVID-19 diagnosis in dementia patients and the controls was 23.7% versus 1.7%, respectively, before propensity score matching (PSM) (p < 0.001), and 23.7% versus 9.2% after PSM (p < 0.001). The hazard ratio (HR) for mortality within 14 days in COVID-19 patients with dementia was significant even after PSM (HR 5.104, 95% confidence interval 2.889-5.673, p < 0.001). The survival curve of dementia patients was steeply inclined within 14 days after COVID-19 diagnosis, resulting in 70.7% of all deaths in dementia patients.
COVID-19 patients with dementia had a higher risk of early death within 14 days. Thus, prompt intervention is necessary for dementia patients after COVID-19 diagnosis.
本研究评估了新冠肺炎(COVID-19)诊断后 14 天内痴呆患者的死亡率升高风险。
本回顾性研究于 2020 年 2 月至 4 月期间,使用韩国疾病控制与预防署的 COVID-19 患者数据库进行。使用逐步进行的广义逻辑回归确定 14 天内早期死亡的风险因素。使用 COVID-19 诊断的痴呆患者作为研究对象。包括倾向评分匹配队列作为对照。评估 COVID-19 诊断后 14 天内痴呆患者和对照组的死亡率差异。
我们从数据库中纳入了 5349 名 COVID-19 患者;其中 224 名患有合并症痴呆。在进行倾向评分匹配(PSM)之前,痴呆患者和对照组 COVID-19 诊断后 14 天内的死亡率分别为 23.7%和 1.7%(p < 0.001),在 PSM 后分别为 23.7%和 9.2%(p < 0.001)。即使在 PSM 后,痴呆 COVID-19 患者 14 天内死亡的风险比(HR)仍然显著(HR 5.104,95%置信区间 2.889-5.673,p < 0.001)。COVID-19 诊断后 14 天内痴呆患者的生存曲线急剧倾斜,导致痴呆患者的所有死亡中有 70.7%发生在这一时期。
患有痴呆的 COVID-19 患者在 14 天内有更高的早期死亡风险。因此,COVID-19 诊断后需要对痴呆患者进行及时干预。