The Impact of Dementia on the Clinical Outcome of COVID-19: A Systematic Review and Meta-Analysis

J Alzheimers Dis. 2020;78(4):1775-1782. doi: 10.3233/JAD-201016.

Abstract

Background: The emergence of the coronavirus disease 2019 (COVID-19) has brought large challenges to dementia patients. We reviewed the existing literature on COVID-19 to assess the incidence and mortality of dementia comorbidities in COVID-19 patients.

Objective: To investigate the impact of pre-existing dementia comorbidities on COVID-19.

Methods: We searched the PubMed, Embase, and Web of Science databases for patients with preexisting dementia who were diagnosed with COVID-19. The statistical data on the prevalence and mortality of dementia comorbidities were examined. A fixed-or random-effect model was used to calculate the overall pooled risk estimates. Forest plots were generated to show the summarized results.

Results: A total of 265 articles were retrieved from the three databases. After removing duplicates and performing two screenings, 10 articles were selected for meta-analysis, including 119,218 participants. Overall, the meta-analysis of the 10 studies showed that the incidence of dementia in COVID-19 patients was (R: 9%, [95% CI: 6% to 13%]). Moreover, the meta-analysis of 9 studies showed that the mortality rate of individuals with dementia after being infected with COVID-19 was higher than that of individuals with no dementia (OR: 5.17 [95% CI: 2.31 to 11.59]). Substantial heterogeneity was observed in this meta-analysis. Significant publication bias was also found.

Conclusion: Emerging literature shows that dementia comorbidities are a high risk factor for the prevalence and mortality of COVID-19. Our results should have an impact on preventive interventions and encourage more targeted approaches to prioritize older people with specific risk factors, such as dementia.

Keywords: Alzheimer’s disease; coronavirus disease 2019; dementia; meta-analysis.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alzheimer Disease / complications
  • Alzheimer Disease / epidemiology
  • Alzheimer Disease / mortality
  • COVID-19 / complications*
  • COVID-19 / epidemiology
  • COVID-19 / mortality
  • COVID-19 / therapy*
  • Dementia / complications*
  • Dementia / epidemiology
  • Dementia / mortality
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Prevalence
  • Treatment Outcome