Qureshi Adnan I, Baskett William I, Huang Wei, Naqvi S Hasan, Shyu Chi-Ren
Zeenat Qureshi Stroke Institutes and Department of Neurology, University of Missouri, Columbia, Missouri, USA.
Institute for Data Science and Informatics, University of Missouri, Columbia, Missouri, USA.
Open Forum Infect Dis. 2022 Mar 7;9(4):ofac115. doi: 10.1093/ofid/ofac115. eCollection 2022 Apr.
Case series without control groups suggest that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may result in cognitive deficits and dementia in the postinfectious period.
Adult pneumonia patients with SARS-CoV-2 infection (index hospitalization) and age-, gender-, and race/ethnicity-matched contemporary control pneumonia patients without SARS-CoV-2 infection were identified from 110 healthcare facilities in United States. The risk of new diagnosis of dementia following >30 days after the index hospitalization event without any previous history of dementia was identified using logistic regression analysis to adjust for potential confounders.
Among 10 403 patients with pneumonia associated with SARS-CoV-2 infection, 312 patients (3% [95% confidence interval {CI}, 2.7%-3.4%]) developed new-onset dementia over a median period of 182 days (quartile 1 = 113 days, quartile 3 = 277 days). After adjustment for age, gender, race/ethnicity, hypertension, diabetes mellitus, hyperlipidemia, nicotine dependence/tobacco use, alcohol use/abuse, atrial fibrillation, previous stroke, and congestive heart failure, the risk of new-onset dementia was significantly higher with pneumonia associated with SARS-CoV-2 infection compared with pneumonia unrelated to SARS-CoV-2 infection (odds ratio [OR], 1.3 [95% CI, 1.1-1.5]). The association remained significant after further adjustment for occurrence of stroke, septic shock, and intubation/mechanical ventilation during index hospitalization (OR, 1.3 [95% CI, 1.1-1.5]).
Approximately 3% of patients with pneumonia associated with SARS-CoV-2 infection developed new-onset dementia, which was significantly higher than the rate seen with other pneumonias.
无对照组的病例系列研究表明，严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染可能在感染后导致认知缺陷和痴呆。
从美国110家医疗机构中确定患有SARS-CoV-2感染的成年肺炎患者（首次住院）以及年龄、性别和种族/民族相匹配的同期未感染SARS-CoV-2的对照肺炎患者。使用逻辑回归分析确定在首次住院事件30天后无任何痴呆病史的情况下新诊断痴呆的风险，以调整潜在的混杂因素。
在10403例与SARS-CoV-2感染相关的肺炎患者中，312例患者（3%[95%置信区间{CI}，2.7%-3.4%]）在中位时间182天（四分位数1 = 113天，四分位数3 = 277天）内出现新发痴呆。在调整年龄、性别、种族/民族、高血压、糖尿病、高脂血症、尼古丁依赖/吸烟、酒精使用/滥用、心房颤动、既往中风和充血性心力衰竭后，与未感染SARS-CoV-2的肺炎相比，感染SARS-CoV-2的肺炎患者新发痴呆的风险显著更高（比值比[OR]，1.3[95%CI，1.1-1.5]）。在进一步调整首次住院期间中风、感染性休克和插管/机械通气的发生情况后，该关联仍然显著（OR，1.3[95%CI，1.1-1.5]）。
约3%的SARS-CoV-2感染相关肺炎患者出现新发痴呆，这一比例显著高于其他肺炎患者。
