Journal of Alzheimer’s Disease ( IF 4 ) Pub Date : 2021-09-16 , DOI: 10.3233/jad-210319 Jeanine J S Rutten 1 , Janine van Kooten 1 , Anouk M van Loon 1 , Laura W van Buul 1 , Karlijn J Joling 1 , Martin Smalbrugge 1 , Cees M P M Hertogh 1
Abstract
Background:
The COVID-19 pandemic has led to high mortality rates in nursing homes (NHs) in Europe. For adequate risk management and good prognostications, it is essential to identify mortality risk factors.
Objective:
This study aimed to determine whether previously identified risk factors for 30-day mortality in Dutch NH residents with COVID-19 are unique to COVID-19.
Methods:
In this cohort study, we included 1,294 NH residents with COVID-19 (cases) and 17,999 NH residents without COVID-19 (controls, from the pre-COVID-19 period). We used descriptive statistics and Cox proportional hazard models to compare mortality rates in residents with and without COVID-19, categorized by risk factors.
Results:
Cases had a more than 18 times higher hazard of death within 30 days compared to controls (HR 18, 95%CI: 16–20). For residents with COVID-19, being male, having dementia, and having Parkinson’s disease (PD) were all associated with a higher 30-day mortality (HR 1.8 versus 1.3 versus 1.7). Being male was also associated with a higher mortality (HR 1.7) in the control group, whereas having dementia and PD were not. COVID-19 symptomatology was very similar for residents with and without dementia or PD, except for delirium and malaise which was more frequent in residents with dementia.
Conclusion:
Dementia and PD were significant additional risk factors for mortality in Dutch NH residents with COVID-19, whereas male gender was not unique to residents with COVID-19. The frailty of PD and dementia in NH residents with COVID-19 are relevant to consider in prognostication, communication, and care planning with residents and their families.
中文翻译:
痴呆症和帕金森病:COVID-19 疗养院居民 30 天死亡率的危险因素
摘要
背景:
COVID-19 大流行导致欧洲疗养院 (NH) 的死亡率很高。为了充分的风险管理和良好的预后,确定死亡风险因素至关重要。
客观的:
本研究旨在确定先前确定的 COVID-19 荷兰新罕布什尔州居民 30 天死亡率的风险因素是否是 COVID-19 独有的。
方法:
在这项队列研究中,我们纳入了 1,294 名患有 COVID-19(病例)的 NH 居民和 17,999 名没有 COVID-19 的 NH 居民(对照,来自 COVID-19 之前的时期)。我们使用描述性统计数据和 Cox 比例风险模型来比较有和没有 COVID-19 的居民的死亡率,按风险因素分类。
结果:
与对照组相比,病例在 30 天内的死亡风险高出 18 倍以上(HR 18,95% CI:16-20)。对于患有 COVID-19 的居民,男性、痴呆症和帕金森病 (PD) 都与较高的 30 天死亡率相关(HR 1.8 vs 1.3 vs 1.7)。在对照组中,男性也与较高的死亡率(HR 1.7)相关,而患有痴呆症和 PD 则不然。患有和未患有痴呆症或 PD 的居民的 COVID-19 症状非常相似,除了在患有痴呆症的居民中更常见的谵妄和不适。
结论:
痴呆症和 PD 是 COVID-19 荷兰新罕布什尔州居民死亡的重要额外风险因素,而男性并非 COVID-19 居民独有。患有 COVID-19 的 NH 居民的 PD 和痴呆症的脆弱性与居民及其家人的预后、沟通和护理计划相关。