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COVID‐19 and dementia: Analyses of risk, disparity, and outcomes from electronic health records in the US

Introduction

At present, there is limited data on the risks, disparity, and outcomes for COVID‐19 in patients with dementia in the United States.

Methods

This is a retrospective case‐control analysis of patient electronic health records (EHRs) of 61.9 million adult and senior patients (age ≥ 18 years) in the United States up to August 21, 2020.

Results

Patients with dementia were at increased risk for COVID‐19 compared to patients without dementia (adjusted odds ratio [AOR]: 2.00 [95% confidence interval (CI), 1.94–2.06], P < .001), with the strongest effect for vascular dementia (AOR: 3.17 [95% CI, 2.97–3.37], P < .001), followed by presenile dementia (AOR: 2.62 [95% CI, 2.28–3.00], P < .001), Alzheimer's disease (AOR: 1.86 [95% CI, 1.77–1.96], P < .001), senile dementia (AOR: 1.99 [95% CI, 1.86–2.13], P < .001) and post‐traumatic dementia (AOR: 1.67 [95% CI, 1.51–1.86] P < .001). Blacks with dementia had higher risk of COVID‐19 than Whites (AOR: 2.86 [95% CI, 2.67–3.06], P < .001). The 6‐month mortality and hospitalization risks in patients with dementia and COVID‐19 were 20.99% and 59.26%, respectively.

Discussion

These findings highlight the need to protect patients with dementia as part of the strategy to control the COVID‐19 pandemic.


1 INTRODUCTION

Coronavirus disease 2019 (COVID‐19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV 2) and rapidly escalated into a global pandemic.1 Severe illness of COVID‐19 predominantly occurs in older people and in individuals with underlying medical comorbidities.2 Dementia including Alzheimer disease (AD) is a common cause of morbidity and mortality in the aging population.3 In addition, the majority of people with dementia were living with one or two additional chronic health conditions.4-6 Currently, there is little if any quantitative analysis of the risks and outcomes for COVID‐19 in individuals with AD or dementia in the United States.



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