Cognitive Impairment Is a Common Comorbidity in Deceased COVID-19 Patients: A Hospital-Based Retrospective Cohort Study

  1. Paloma Martín-Jiménez
  2. Mariana I. Muñoz-García
  3. David Seoane
  4. Lucas Roca-Rodríguez
  5. Ana García-Reyne
  6. Antonio Lalueza
  7. Guillermo Maestro
  8. Dolores Folgueira
  9. Víctor A. Blanco-Palmero
  10. Alejandro Herrero-San Martín
  11. Sara Llamas-Velasco
  12. David A. Pérez-Martínez
  13. Marta González-Sánchez
  14. Alberto Villarejo-Galende

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Abstract

We analyzed the frequency of cognitive impairment (CI) in deceased COVID-19 patients at a tertiary hospital in Spain. Among the 477 adult cases who died after admission from March 1 to March 31, 2020, 281 had confirmed COVID-19. CI (21.1% dementia and 8.9% mild cognitive impairment) was a common comorbidity. Subjects with CI were older, tended to live in nursing homes, had shorter time from symptom onset to death, and were rarely admitted to the ICU, receiving palliative care more often. CI is a frequent comorbidity in deceased COVID-19 subjects and is associated with differences in care.

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  1. Version published to 10.3233/jad-200937
  2. ScreenIT

    SciScore for 10.1101/2020.06.08.20125872: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: Patients were included in three groups according to COVID-19 status, following the case definition of the European Centre for Diseases Prevention and control (10): The study was reviewed and approved by the local ethics committee / institutional review board (EC/IRB).
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Statistical analyses were undertaken using STATA software 14.0 (StataCorp, College Station, TX).
    STATA
    suggested: (Stata, RRID:SCR_012763)
    StataCorp
    suggested: (Stata, RRID:SCR_012763)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Our study has some limitations. First, due to its retrospective design, information about some of the variables may be incomplete. We tried to carefully review all the clinical notes in the electronic medical records, but some diagnoses of CI may not have been recorded. Second, only fatal cases of COVID-19 were included, and we cannot analyse whether CI is a risk factor for mortality in COVID-19. Third, the study is hospital-based, and many community-based cohort studies have shown that not all the persons with dementia seek medical attention, especially those who are very old or have a lower socio-economic status (15). More importantly, health authorities and research reports are describing a high case fatality rate of COVID-19 in nursing homes (16), where people are dying without hospital transfer. By April 17, 2020, more than 20,000 people with confirmed COVID-19 had died in Spain, 7,132 of them in the Community of Madrid (17). These numbers are distressing, but they probably reflect only a part of the impact of COVID-19. The local health authorities have reported that from March 8 to April 17, 2020, 5,272 of the 44,132 nursing home residents in the Madrid region have died with symptoms of COVID-19, but the disease could only be confirmed in 837 of them (18). Considering that the estimated prevalence of dementia in nursing homes of western European countries ranges from 50 to 75% (19), the number of deaths in people with dementia during the COVID-19 pandemic will be probab...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

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  3. Version published to 10.1101/2020.06.08.20125872v1 on medRxiv