TY - JOUR
T1 - Clinical outcomes of COVID-19 infection among patients with Alzheimer's disease or mild cognitive impairment
AU - Wang, Ying
AU - Li, Mingfei
AU - Kazis, Lewis E.
AU - Xia, Weiming
N1 - Funding Information:
All authors have declared that no competing interests exist. We are reporting a retrospective study of medical records. All data were fully anonymized before we accessed them. Administrative data was extracted from the COVID‐19 Shared Data Resource/Corporate Data Warehouse at the VA Informatics and Computing Infrastructure (VINCI) Resource Center. There was no direct human subject enrollment for this study. This study was supported by the award COVID19‐8900‐06 from the Clinical Service Research and Development of the Veterans Affairs Office of Research and Development (WX) and RF1AG063913 from the NIH (WX). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The views expressed in this article are those of the authors and do not represent the views of the US Department of Veterans Affairs and the US Government.
Publisher Copyright:
US Government Published 2022. This article is a U.S. Government work and is in the public domain in the USA.
PY - 2022/5
Y1 - 2022/5
N2 - Introduction: Alzheimer's disease (AD) and COVID-19 share common risk factors including hypertension. Angiotensin converting enzyme inhibitors (ACEI) and angiotensin II receptor blockers (ARB) are frequently prescribed antihypertension medications. Methods: This study analyzed 436,823 veterans tested for SARS-CoV-2 infection. We conducted both classical and propensity score weighted logistic models to compare COVID-19 outcomes between patients with AD or mild cognitive impairment (MCI) to those without cognitive impairment, and examined effect of ACEI/ARB prescription. Results: There was a statistically significant association between AD and increased odds of infection and mortality. MCI was not found to be a risk factor for infection. Subjects with MCI exhibited poor clinical outcomes. Prescribing ARBs but not ACEIs was significantly associated with a lower risk of COVID-19 occurrence among AD and MCI patients. Discussion: Exploring beneficial effects of existing medications to reduce the impact of COVID-19 on patients with AD or MCI is highly significant. Highlights: There is significant association between Alzheimer's disease (AD) and increased risk of COVID-19 infection and odds of mortality. Subjects with mild cognitive impairment (MCI) defined by claims data exhibit poor clinical outcomes, but MCI was not found to be a risk factor for severe acute respiratory syndrome coronavirus 2 infection. Prescribing angiotensin II receptor blockers was significantly associated with a lower risk of COVID-19 occurrence among AD/MCI patients.
AB - Introduction: Alzheimer's disease (AD) and COVID-19 share common risk factors including hypertension. Angiotensin converting enzyme inhibitors (ACEI) and angiotensin II receptor blockers (ARB) are frequently prescribed antihypertension medications. Methods: This study analyzed 436,823 veterans tested for SARS-CoV-2 infection. We conducted both classical and propensity score weighted logistic models to compare COVID-19 outcomes between patients with AD or mild cognitive impairment (MCI) to those without cognitive impairment, and examined effect of ACEI/ARB prescription. Results: There was a statistically significant association between AD and increased odds of infection and mortality. MCI was not found to be a risk factor for infection. Subjects with MCI exhibited poor clinical outcomes. Prescribing ARBs but not ACEIs was significantly associated with a lower risk of COVID-19 occurrence among AD and MCI patients. Discussion: Exploring beneficial effects of existing medications to reduce the impact of COVID-19 on patients with AD or MCI is highly significant. Highlights: There is significant association between Alzheimer's disease (AD) and increased risk of COVID-19 infection and odds of mortality. Subjects with mild cognitive impairment (MCI) defined by claims data exhibit poor clinical outcomes, but MCI was not found to be a risk factor for severe acute respiratory syndrome coronavirus 2 infection. Prescribing angiotensin II receptor blockers was significantly associated with a lower risk of COVID-19 occurrence among AD/MCI patients.
KW - Alzheimer's disease
KW - COVID-19
KW - angiotensin II receptor blockers
KW - angiotensin converting enzyme inhibitors
KW - mild cognitive impairment
KW - severe acute respiratory syndrome coronavirus 2
KW - Angiotensin-Converting Enzyme Inhibitors/therapeutic use
KW - Cognitive Dysfunction/complications
KW - Humans
KW - Hypertension/complications
KW - SARS-CoV-2
KW - Retrospective Studies
KW - Angiotensin Receptor Antagonists/therapeutic use
KW - Alzheimer Disease/complications
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U2 - 10.1002/alz.12665
DO - 10.1002/alz.12665
M3 - Article
C2 - 35377523
AN - SCOPUS:85127392165
SN - 1552-5260
VL - 18
SP - 911
EP - 923
JO - Alzheimer's and Dementia
JF - Alzheimer's and Dementia
IS - 5
ER -