Bohlken Jens, Weber Kerstin, Riedel Heller Steffi, Michalowsky Bernhard, Kostev Karel
Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP) der Medizinischen Fakultät der Universität Leipzig, Germany.
Impfzentrum Messe 21, Berlin, Germany.
J Alzheimers Dis Rep. 2022 Jun 9;6(1):297-305. doi: 10.3233/ADR-220020. eCollection 2022.
Little is known about the impact of COVID-19 on mild cognitive disorder.
The aim of this retrospective cohort study was to investigate whether COVID-19 diagnosis is associated with subsequent mild cognitive disorder (MCD) compared to acute upper respiratory infections (AURI).
This retrospective cohort study used data from the Disease Analyzer database (IQVIA) and included 67,046 patients with first-time symptomatic or asymptomatic COVID-19 diagnoses in 1,172 general practices in Germany between March 2020 and September 2021. Diagnoses were based on ICD-10 codes. Patients diagnosed with AURI were matched to 67,046 patients with COVID-19 using propensity scores based on sex, age, index month, and comorbidities. The index date was the diagnosis date for either COVID-19 or AURI. Associations between the COVID-19 and MCD were studied using conditional Poisson regression models.
The incidence of MCD was 7.6 cases per 1,000 person-years in the COVID-19 group and 5.1 cases per 1,000 person-years in the AURI group (IRR = 1.49, 95% CI = 1.22-1.82). The incidence rate ratio decreased strongly with increasing age from 10.08 (95% CI = 4.00-24.42) in the age group≤50 to 1.03 (95% CI = 0.81-1.31) in the age group > 70. In addition, the association between COVID-19 and MCD was significant in women (IRR: 1.70, 95% CI: 1.34-2.16) but not in men (IRR: 1.08, 95% CI: 0.75-1.56).
The incidence of MCD was low but significantly higher in COVID-19 than in AURI patients, especially among younger patients. If a cognitive disorder is suspected, referral to a specialist is recommended.
关于新型冠状病毒肺炎（COVID-19）对轻度认知障碍的影响，人们了解甚少。
这项回顾性队列研究旨在调查与急性上呼吸道感染（AURI）相比，COVID-19诊断是否与随后发生的轻度认知障碍（MCD）相关。
这项回顾性队列研究使用了疾病分析器数据库（IQVIA）的数据，纳入了2020年3月至2021年9月期间德国1172家普通诊所中67046例首次出现症状性或无症状性COVID-19诊断的患者。诊断基于国际疾病分类第十版（ICD-10）编码。使用基于性别、年龄、索引月份和合并症的倾向得分，将诊断为AURI的患者与67046例COVID-19患者进行匹配。索引日期为COVID-19或AURI的诊断日期。使用条件泊松回归模型研究COVID-19与MCD之间的关联。
COVID-19组中MCD的发病率为每1000人年7.6例，AURI组为每1000人年5.1例（发病率比[IRR] = 1.49，95%置信区间[CI] = 1.22 - 1.82）。发病率比随着年龄的增长而大幅下降，从年龄≤50岁组的10.08（95% CI = 4.00 - 24.42）降至年龄>70岁组的1.03（95% CI = 0.81 - 1.31）。此外，COVID-19与MCD之间的关联在女性中显著（IRR：1.70，95% CI：1.34 - 2.16），而在男性中不显著（IRR：1.08，95% CI：0.75 - 1.56）。
MCD的发病率较低，但COVID-19患者中的发病率显著高于AURI患者，尤其是在年轻患者中。如果怀疑有认知障碍，建议转诊至专科医生处。
