Produção Nacional
Revisado por pares
Clinical characteristics and outcomes of COVID-19 patients with preexisting dementia: a large multicenter propensity-matched Brazilian cohort study
2024; BioMed Central; Volume: 24; Issue: 1 Linguagem: Inglês
10.1186/s12877-023-04494-w
ISSN1471-2318
AutoresMaria Aparecida Camargos Bicalho, Márlon Juliano Romero Aliberti, Polianna Delfino-Pereira, Victor Schulthais Chagas, Patryk Marques da Silva Rosa, Magda Carvalho Pires, Lucas Emanuel Ferreira Ramos, Adriana Falangola Benjamin Bezerra, Ana Beatriz de Castro Feres, Angélica Gomides dos Reis Gomes, Angelinda Rezende Bhering, Bruno Porto Pessoa, Carla Thaís Cândida Alves da Silva, Christiane Corrêa Rodrigues Cimini, Cláudia Kimie Suemoto, Cristiana Andrade Coelho Dias, Daniela dos Reis Carazai, Daniela Ponce, Danyelle Romana Alves Rios, Euler Roberto Fernandes Manenti, Fernando Anschau, Joanna d’Arc Lyra Batista, Joice Coutinho de Alvarenga, Julia Avancini Viguini, Julia Mariot Zanellato, Juliana Machado-Rugolo, Karen Brasil Ruschel, Letícia do Nascimento, Luanna Silva Monteiro Menezes, Lucas Moysés Carvalho de Oliveira, Luís César de Castro, Luiz Antônio Nasi, Marcelo Carneiro, Maria Angélica Pires Ferreira, Mariana Frizzo de Godoy, Milton Henriques Guimarães Júnior, Neimy Ramos de Oliveira, Patrícia Klarmann Ziegelmann, Paula Fonseca Porto, Paulo Mascarenhas Mendes, Pedro Gibson Paraíso, Priscilla Pereira dos Reis, Saionara Cristina Francisco, Silvia Ferreira Araújo, Thiago Junqueira Avelino‐Silva, Milena Soriano Marcolino,
Tópico(s)Frailty in Older Adults
ResumoAbstract Background Although dementia has emerged as an important risk factor for severe SARS-CoV-2 infection, results on COVID-19-related complications and mortality are not consistent. We examined the clinical presentations and outcomes of COVID-19 in a multicentre cohort of in-hospital patients, comparing those with and without dementia. Methods This retrospective observational study comprises COVID-19 laboratory-confirmed patients aged ≥ 60 years admitted to 38 hospitals from 19 cities in Brazil. Data were obtained from electronic hospital records. A propensity score analysis was used to match patients with and without dementia (up to 3:1) according to age, sex, comorbidities, year, and hospital of admission. Our primary outcome was in-hospital mortality. We also assessed admission to the intensive care unit (ICU), invasive mechanical ventilation (IMV), kidney replacement therapy (KRT), sepsis, nosocomial infection, and thromboembolic events. Results Among 1,556 patients included in the study, 405 (4.5%) had a diagnosis of dementia and 1,151 were matched controls. When compared to matched controls, patients with dementia had a lower frequency of dyspnoea, cough, myalgia, headache, ageusia, and anosmia; and higher frequency of fever and delirium. They also had a lower frequency of ICU admission (32.7% vs. 47.1%, p < 0.001) and shorter ICU length of stay (7 vs. 9 days, p < 0.026), and a lower frequency of sepsis (17% vs. 24%, p = 0.005), KRT (6.4% vs. 13%, p < 0.001), and IVM (4.6% vs. 9.8%, p = 0.002). There were no differences in hospital mortality between groups. Conclusion Clinical manifestations of COVID-19 differ between older inpatients with and without dementia. We observed that dementia alone could not explain the higher short-term mortality following severe COVID-19. Therefore, clinicians should consider other risk factors such as acute morbidity severity and baseline frailty when evaluating the prognosis of older adults with dementia hospitalised with COVID-19.
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