Geriatric Research Education and Clinical Center, Bedford VA Healthcare System, Bedford, Massachusetts, USA.
Department of Mathematical Sciences, Bentley University, Waltham, Massachusetts, USA.
Alzheimers Dement. 2022 May;18(5):911-923. doi: 10.1002/alz.12665. Epub 2022 Apr 4.
Alzheimer's disease (AD) and COVID-19 share common risk factors including hypertension. Angiotensin converting enzyme inhibitors (ACEI) and angiotensin II receptor blockers (ARB) are frequently prescribed antihypertension medications.
This study analyzed 436,823 veterans tested for SARS-CoV-2 infection. We conducted both classical and propensity score weighted logistic models to compare COVID-19 outcomes between patients with AD or mild cognitive impairment (MCI) to those without cognitive impairment, and examined effect of ACEI/ARB prescription.
There was a statistically significant association between AD and increased odds of infection and mortality. MCI was not found to be a risk factor for infection. Subjects with MCI exhibited poor clinical outcomes. Prescribing ARBs but not ACEIs was significantly associated with a lower risk of COVID-19 occurrence among AD and MCI patients.
Exploring beneficial effects of existing medications to reduce the impact of COVID-19 on patients with AD or MCI is highly significant.
There is significant association between Alzheimer's disease (AD) and increased risk of COVID-19 infection and odds of mortality. Subjects with mild cognitive impairment (MCI) defined by claims data exhibit poor clinical outcomes, but MCI was not found to be a risk factor for severe acute respiratory syndrome coronavirus 2 infection. Prescribing angiotensin II receptor blockers was significantly associated with a lower risk of COVID-19 occurrence among AD/MCI patients.
阿尔茨海默病（AD）和 COVID-19 有共同的危险因素，包括高血压。血管紧张素转换酶抑制剂（ACEI）和血管紧张素 II 受体阻滞剂（ARB）是常用的降压药物。
本研究分析了 436823 名接受 SARS-CoV-2 感染检测的退伍军人。我们分别进行了经典和倾向评分加权逻辑模型分析，以比较 AD 或轻度认知障碍（MCI）患者与无认知障碍患者的 COVID-19 结局，并研究 ACEI/ARB 处方的效果。
AD 与感染和死亡率增加的几率存在统计学显著关联。MCI 不是感染的危险因素。MCI 患者的临床结局较差。ARB 处方而非 ACEI 处方与 AD 和 MCI 患者 COVID-19 发生率降低显著相关。
探索现有药物的有益作用，以降低 COVID-19 对 AD 或 MCI 患者的影响具有重要意义。
AD 与 COVID-19 感染和死亡率增加的几率存在显著关联。通过索赔数据定义的轻度认知障碍（MCI）患者的临床结局较差，但 MCI 不是严重急性呼吸综合征冠状病毒 2 感染的危险因素。ARB 处方与 AD/MCI 患者 COVID-19 发生率降低显著相关。
