Zhang Qianru, Botta Ragasudha, Xu Ying, Wei James Cheng-Chung, Tung Tao-Hsin
Department of Rheumatology and Immunology, Tsinghua University Affiliated Beijing Tsinghua Changgung Hospital, Beijing, China.
Harvard Medical School, Boston, MA 02115-6027, USA.
Age Ageing. 2025 Mar 3;54(3). doi: 10.1093/ageing/afaf046.
Emerging evidence suggests coronavirus disease 2019 (COVID-19) infection may increase the risk of developing dementia, although studies have reported conflicting findings. This meta-analysis aimed to synthesise the literature on the association between COVID-19 and the risk of new-onset dementia.
PubMed, Embase and Web of Science were searched for cohort studies or case-control studies that investigated new-onset dementia development among adult COVID-19 survivors compared to individuals without COVID-19 infection from inception to 9 November 2023. Studies that exclusively involved populations younger than 18 years, with known dementia or lacked adequate data about the risk of dementia were excluded. Two authors independently conducted the screening of eligible studies, data extraction and risk of bias assessment. The primary outcome was new-onset dementia following COVID-19 infection. Data were pooled using random-effects models, with hazard ratios (HRs) and 95% confidence intervals (CIs) calculated.
A total of 15 retrospective cohort studies encompassing 26 408 378 participants were included. Pooled analysis indicated COVID-19 was associated with an increased risk of new-onset dementia (HR = 1.49, 95% CI: 1.33-1.68). This risk remained elevated when compared with non-COVID cohorts (HR = 1.65, 95% CI: 1.39-1.95), and respiratory tract infection cohorts (HR = 1.29, 95% CI: 1.12-1.49), but not influenza or sepsis cohorts. Increased dementia risk was observed in both males and females, as well as in individuals older than 65 years (HR = 1.68, 95% CI: 1.48-1.90), with the risk remaining elevated for up to 24 months.
This meta-analysis demonstrates a significant association between COVID-19 infection and increased risk of developing new-onset dementia, which underscores the need for cognitive monitoring and early intervention for COVID-19 survivors to address potential long-term neurological impacts.
新出现的证据表明，2019冠状病毒病（COVID-19）感染可能会增加患痴呆症的风险，尽管各项研究报告的结果相互矛盾。本荟萃分析旨在综合关于COVID-19与新发痴呆症风险之间关联的文献。
检索了PubMed、Embase和Web of Science数据库，查找自研究开始至2023年11月9日期间，调查成年COVID-19幸存者与未感染COVID-19的个体相比新发痴呆症发生情况的队列研究或病例对照研究。专门涉及18岁以下人群、已知患有痴呆症或缺乏痴呆症风险相关充分数据的研究被排除。两位作者独立进行符合条件研究的筛选、数据提取和偏倚风险评估。主要结局是COVID-19感染后新发痴呆症。使用随机效应模型汇总数据，计算风险比（HRs）和95%置信区间（CIs）。
共纳入15项回顾性队列研究，涉及26408378名参与者。汇总分析表明，COVID-19与新发痴呆症风险增加相关（HR = 1.49，95% CI：1.33 - 1.68）。与非COVID队列（HR = 1.65，95% CI：1.39 - 1.95）和呼吸道感染队列（HR = 1.29，95% CI：1.12 - 1.49）相比，这种风险仍然升高，但与流感或败血症队列相比则不然。在男性和女性以及65岁以上个体中均观察到痴呆症风险增加（HR = 1.68，95% CI：1.48 - 1.90），风险在长达24个月内一直保持升高。
本荟萃分析表明，COVID-19感染与新发痴呆症风险增加之间存在显著关联，这突出了对COVID-19幸存者进行认知监测和早期干预以应对潜在长期神经影响的必要性。
