Hadidchi Roham, Pakan Rachel, Alamuri Tharun, Cercizi Noel, Al-Ani Yousef, Wang Stephen H, Henry Sonya, Duong Tim Q
Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA.
Stony Brook University Renaissance School of Medicine, Stony Brook, NY, USA.
J Alzheimers Dis. 2025 Jan;103(2):605-615. doi: 10.1177/13872877241303934. Epub 2024 Dec 16.
Although COVID-19 has been linked to worse acute outcomes in patients with some neurodegenerative disorders, its long-term impact on dementia remains unclear.
To investigate the outcomes of COVID-19 survivors with dementia.
This retrospective study evaluated 9806 patients with dementia in the Montefiore Health System (January 2016 to July 2023). Comparisons were made between dementia patients with and without a positive SARS-CoV-2 polymerase-chain-reaction test who had a follow-up at least two weeks post-infection. Outcomes included all-cause mortality, major adverse cardiovascular events (MACE), new-onset dysphagia, dyspnea, fatigue, new-onset sleep disturbances, altered mental status, first-time fall, headache, new-onset depression, and new-onset anxiety. Adjusted hazard ratios (aHR) were computed adjusting for age, sex, race, ethnicity, and pre-existing comorbidities.
Dementia patients with COVID-19 were younger, more likely to be male, and had a higher prevalence of major pre-existing comorbidities compared to those without COVID-19. Patients who survived acute COVID-19 were more likely to die than non-COVID controls after adjusting for covariates (aHR = 1.65 [1.43, 1.91]). COVID-19 was significantly associated with higher risk of MACE (aHR = 1.58 [1.41, 1.78]), new-onset dysphagia (aHR = 1.64 [1.42, 1.91]), dyspnea (aHR = 1.27 [1.12, 1.44]), fatigue (aHR = 1.42 [1.22, 1.65]), new-onset sleep disturbances (aHR = 1.36 [1.15, 1.60]), altered mental status (aHR = 1.36 [1.16, 1.59]), and first-time fall (aHR = 1.34 [1.09, 1.65]).
COVID-19 increases the risk of mortality and other adverse health outcomes in dementia patients. These findings highlight the need for closer follow-up and management strategies for dementia patients post-COVID-19.
尽管新冠病毒病（COVID-19）已被认为与某些神经退行性疾病患者更差的急性预后相关，但其对痴呆症的长期影响仍不清楚。
调查感染COVID-19后存活的痴呆症患者的预后情况。
这项回顾性研究评估了蒙特菲奥里医疗系统中9806例痴呆症患者（2016年1月至2023年7月）。对严重急性呼吸综合征冠状病毒2（SARS-CoV-2）聚合酶链反应检测呈阳性和阴性的痴呆症患者进行比较，这些患者在感染后至少随访两周。结局指标包括全因死亡率、主要不良心血管事件（MACE）、新发吞咽困难、呼吸困难、疲劳、新发睡眠障碍、精神状态改变、首次跌倒、头痛、新发抑郁和新发焦虑。计算调整年龄、性别、种族、民族和既往合并症后的调整风险比（aHR）。
与未感染COVID-19的痴呆症患者相比，感染COVID-19的痴呆症患者更年轻，男性比例更高，主要既往合并症的患病率更高。在调整协变量后，急性COVID-19存活患者比未感染COVID-19的对照患者死亡可能性更高（aHR = 1.65 [1.43, 1.91]）。COVID-19与MACE风险更高（aHR = 1.58 [1.41, 1.78]）、新发吞咽困难（aHR = 1.64 [1.42, 1.91]）、呼吸困难（aHR = 1.27 [1.12, 1.44]）、疲劳（aHR = 1.42 [1.22, 1.65]）、新发睡眠障碍（aHR = 1.36 [1.15, 1.60]）、精神状态改变（aHR = 1.36 [1.16, 1.59]）和首次跌倒（aHR = 1.34 [1.09, 1.65]）显著相关。
COVID-19增加了痴呆症患者的死亡风险和其他不良健康结局的风险。这些发现凸显了对COVID-19后痴呆症患者进行密切随访和管理策略的必要性。
