TY - JOUR
T1 - SARS-CoV-2 Susceptibility and COVID-19 Mortality Among Older Adults With Cognitive Impairment
T2 - Cross-Sectional Analysis From Hospital Records in a Diverse US Metropolitan Area
AU - Pan, Alan P.
AU - Meeks, Jennifer
AU - Potter, Thomas
AU - Masdeu, Joseph C.
AU - Seshadri, Sudha
AU - Smith, Matthew Lee
AU - Ory, Marcia G.
AU - Vahidy, Farhaan S.
N1 - Funding Information:
The authors would like to acknowledge infrastructural support provided by the Houston Methodist Research Institute and the Center for Outcomes Research for the Houston Methodist COVID-19 Surveillance and Outcomes Registry (CURATOR).
Publisher Copyright:
© Copyright © 2021 Pan, Meeks, Potter, Masdeu, Seshadri, Smith, Ory and Vahidy.
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
Copyright © 2021 Pan, Meeks, Potter, Masdeu, Seshadri, Smith, Ory and Vahidy.
PY - 2021/7/22
Y1 - 2021/7/22
N2 - Introduction: Persistent knowledge gaps exist as to the extent that preexisting cognitive impairment is a risk factor for susceptibility to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and mortality from the coronavirus disease 2019 (COVID-19). Methods: We conducted a cross-sectional analysis of adults tested for SARS-CoV-2 at a tertiary healthcare system. Cognitive impairment was identified utilizing diagnosis codes (mild cognitive impairment, Alzheimer's disease, vascular, and other dementias) or cognitive impairment-specific medication use. Propensity score (PS) matched analyses were utilized to report odds ratios (OR) and 95% confidence intervals (CI) for association of cognitive impairment with SARS-CoV-2 susceptibility and COVID-19 mortality. Results: Between March-3rd and December-11th, 2020, 179,979 adults were tested, of whom 21,607 (12.0%) tested positive. We identified 6,364 individuals with preexisting cognitive impairment (mean age: 78.5 years, 56.8% females), among whom 843 (13.2%) tested positive and 139 (19.5%) of those hospitalized died. In the pre-PS matched cohort, cognitive impairment was significantly associated with increased SARS-CoV-2 susceptibility (OR, CI: 1.12, 1.04–1.21) and COVID-19 mortality (OR, CI: 2.54, 2.07–3.12). One-to-one matches were identified for 6,192 of 6,364 (97.3%) individuals with prior cognitive impairment and 687 of 712 (96.5%) hospitalized patients with prior cognitive impairment. In the fully balanced post-matched cohort, preexisting cognitive impairment was significantly associated with higher likelihood of SARS-CoV-2 infection (OR, CI: 1.51, 1.35–1.70); however, cognitive impairment did not confer higher risk of COVID-19 mortality (OR, CI: 0.96, 0.73–1.25). Discussion: To mitigate the effects of healthcare catastrophes such as the COVID-19 pandemic, strategies for targeted prevention and risk-stratified comorbidity management are warranted among the vulnerable sub-population living with cognitive impairment.
AB - Introduction: Persistent knowledge gaps exist as to the extent that preexisting cognitive impairment is a risk factor for susceptibility to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and mortality from the coronavirus disease 2019 (COVID-19). Methods: We conducted a cross-sectional analysis of adults tested for SARS-CoV-2 at a tertiary healthcare system. Cognitive impairment was identified utilizing diagnosis codes (mild cognitive impairment, Alzheimer's disease, vascular, and other dementias) or cognitive impairment-specific medication use. Propensity score (PS) matched analyses were utilized to report odds ratios (OR) and 95% confidence intervals (CI) for association of cognitive impairment with SARS-CoV-2 susceptibility and COVID-19 mortality. Results: Between March-3rd and December-11th, 2020, 179,979 adults were tested, of whom 21,607 (12.0%) tested positive. We identified 6,364 individuals with preexisting cognitive impairment (mean age: 78.5 years, 56.8% females), among whom 843 (13.2%) tested positive and 139 (19.5%) of those hospitalized died. In the pre-PS matched cohort, cognitive impairment was significantly associated with increased SARS-CoV-2 susceptibility (OR, CI: 1.12, 1.04–1.21) and COVID-19 mortality (OR, CI: 2.54, 2.07–3.12). One-to-one matches were identified for 6,192 of 6,364 (97.3%) individuals with prior cognitive impairment and 687 of 712 (96.5%) hospitalized patients with prior cognitive impairment. In the fully balanced post-matched cohort, preexisting cognitive impairment was significantly associated with higher likelihood of SARS-CoV-2 infection (OR, CI: 1.51, 1.35–1.70); however, cognitive impairment did not confer higher risk of COVID-19 mortality (OR, CI: 0.96, 0.73–1.25). Discussion: To mitigate the effects of healthcare catastrophes such as the COVID-19 pandemic, strategies for targeted prevention and risk-stratified comorbidity management are warranted among the vulnerable sub-population living with cognitive impairment.
KW - Alzheimer's disease
KW - COVID-19
KW - SARS-CoV-2
KW - cognitive impairment
KW - dementia
KW - patient registries
KW - propensity score matching
UR - http://www.scopus.com/inward/record.url?scp=85112656162&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85112656162&partnerID=8YFLogxK
U2 - 10.3389/fneur.2021.692662
DO - 10.3389/fneur.2021.692662
M3 - Article
C2 - 34367054
AN - SCOPUS:85112656162
SN - 1664-2295
VL - 12
SP - 692662
JO - Frontiers in Neurology
JF - Frontiers in Neurology
M1 - 692662
ER -