Edmiston Elizabeth A, Bej Taissa A, Wilson Brigid, Jump Robin L P, Phillips Joy A
Interprofessional Improvement Research, Education and Clinical Center, VA Northeast Ohio Healthcare System, Cleveland, OH, USA.
Geriatric Research Education and Clinical Center (GRECC), VA Northeast Ohio Healthcare System, Cleveland, OH, USA.
Ther Adv Infect Dis. 2023 May 22;10:20499361231174289. doi: 10.1177/20499361231174289. eCollection 2023 Jan-Dec.
Donepezil is a front-line treatment for Alzheimer's disease. Donepezil treatment is associated with decreased risk of all-cause mortality. Specific protection is observed in pneumonia and cardiovascular disease. We hypothesized that donepezil treatment would improve mortality among Alzheimer's patients following infection with COVID-19. The objective of this study is to assess the influence of ongoing donepezil treatment on survival in Alzheimer's disease patients after polymerase chain reaction (PCR)-confirmed COVID-19 infection.
This is a retrospective cohort study. We conducted a national survey of Veterans with Alzheimer's disease to assess the influence of ongoing donepezil treatment on survival in Alzheimer's disease patients after PCR-confirmed COVID-19 infection. We assessed all-cause 30-day mortality stratified by COVID-19 infection and donepezil use, estimating odds ratios using multivariate logistic regression.
Among people with Alzheimer's disease and COVID-19, all-cause 30-day mortality was 29% (47/163) for people taking donepezil compared with 38% (159/419) for those who were not. Among people with Alzheimer's disease without COVID-19, all-cause 30-day mortality was 5% (189/4189) for people taking donepezil compared with 7% (712/10,241) for those who were not. Adjusting for covariates, the decrease in mortality associated with donepezil did not differ between people with and without COVID-19 (interaction = 0.710).
The known survival benefits of donepezil were retained but not found to be specific to COVID-19 among people with Alzheimer's disease.
多奈哌齐是治疗阿尔茨海默病的一线药物。多奈哌齐治疗与全因死亡率降低相关。在肺炎和心血管疾病方面观察到了特异性保护作用。我们假设多奈哌齐治疗可降低阿尔茨海默病患者感染新型冠状病毒肺炎（COVID-19）后的死亡率。本研究的目的是评估在聚合酶链反应（PCR）确诊COVID-19感染后，持续使用多奈哌齐治疗对阿尔茨海默病患者生存的影响。
这是一项回顾性队列研究。我们对患有阿尔茨海默病的退伍军人进行了全国性调查，以评估在PCR确诊COVID-19感染后，持续使用多奈哌齐治疗对阿尔茨海默病患者生存的影响。我们评估了按COVID-19感染情况和多奈哌齐使用情况分层的全因30天死亡率，使用多变量逻辑回归估计比值比。
在患有阿尔茨海默病和COVID-19的人群中，服用多奈哌齐的患者全因30天死亡率为29%（47/163），未服用者为38%（159/419）。在未感染COVID-19的阿尔茨海默病患者中，服用多奈哌齐的患者全因30天死亡率为5%（189/4189），未服用者为7%（712/10241）。校正协变量后，服用多奈哌齐相关的死亡率降低在感染COVID-19和未感染COVID-19的人群中无差异（交互作用=0.710）。
多奈哌齐已知的生存益处依然存在，但在患有阿尔茨海默病的人群中未发现其对COVID-19具有特异性。
