A study led by Western Asylum University Case Studies researchers found that patients with depression were at much higher risk for COVID-19 – and the risk was even higher for African Americans with dementia.
Reviewing electronic health records of 61.9 million adults in the United States, researchers found that the risk of contracting COVID-19 was twice as high for patients with depression than for those without – and among those with dementia, African Americans were nearly three times more at risk of becoming infected with COVID-19 than Caucasians did.
In addition, patients with depression who contracted COVID-19 had significantly worse outcomes in terms of hospitalizations and deaths than those who had COVID-19 but did not have depression.
The study was published Feb. 9 by the peer-reviewed Alzheimer’s & Dementia: Journal of the Alzheimer’s Society and highlights the need to protect people with dementia – especially African Americans – as part of the strategy to control the pandemic.
An estimated 5.8 million Americans age 65 and older and 50 million people worldwide live with Alzheimer’s and other dementias, according to the Alzheimer’s Society.
“Our findings confirm the importance of protecting people with dementia from receiving SARS-CoV2, as they are at greater risk for serious disease than those without dementia,” he said. study co-author Pamela Davis, dean emerita of the Western Case Reserve School of Medicine. ”These patients may be another vulnerable category. However, more work is needed to understand how this happens. “
The study’s authors also include two other members of the School of Medicine: Rong Xu, principal investigator of the research and professor of biomedical physiology and director of the Center for Artificial Intelligence in Discovery Drugs, and QuanQiu Wang, an expert in artificial intelligence. Co-author Mark Gurney is the founder and CEO of Tetra Therapeutics, a drug development company focused on brain disorders and injuries based in Grand Rapids, Michigan, and a wholly owned subsidiary of Shionogi & Co., Ltd. Ltd.
They assumed that patients with depression would be at greater risk for COVID-19 for a number of reasons, including: People with depression may be more likely to contract from COVID-19 due to blood-brain barrier damage that allows certain viruses and bacteria to reach the brain more easily.
In addition, depression can impair a person’s ability to wear a mask, physically distance themselves from others or clean their hands frequently. In addition, conditions such as cardiovascular disease, diabetes, obesity and hip-tolerance are risk factors for both depression and COVID-19 and are associated with worse outcomes.
“On behalf of the millions of people living with Alzheimer’s and other depression we represent, these preliminary findings reflect the frightening reality of the vulnerabilities associated with pregnancy. Maria Carrillo, PhD, chief science officer for the Alzheimer’s Society, said: “It is vital that we develop and implement strategies that strike a balance between keeping people, especially those with disabilities. long-term care, safe from COVID-19 but also protect them from health-related harm associated with social isolation. “
Researchers examined electronic health records (removed from identifying information) from 360 hospitals and 317,000 providers nationally, representing 20% of the U.S. population. Of the 61.9 million adults in the study population, over one million had depression, 15,770 had COVID-19 and 810 had both.
“Access to such a well-known database of electronic patient health records analyzed with state-of-the-art information methods gave our study great power to detect vulnerabilities in patient disease groups,” Xu said.
The researchers also modified the data to account for factors including age, gender, race, other health conditions and whether individuals were living in a nursing home. They used modified odds ratio to determine risk.
Their conclusions:
- Although contracting COVID-19 appeared to be twice as high for patients with dementia as compared to those without dementia, the risk varied according to the condition. Patients with vascular dementia had the highest risk – with odds more than three times higher – followed by patients with presenile dementia, senile dementia, Alzheimer’s disease and post-traumatic dementia.
- The numbers of African Americans with dementia contracting COVID-19 was almost three times higher than it was for Caucasians with dementia. In general, sex had no additional effect on COVID-19 risk in patients with depression, while age had no additional effect in patients with depression in general and Alzheimer’s in particular. .
- The total hospital risk in the six months for adults with COVID-19 was 25.17%. But among patients with COVID-19 and depression, 59.26% were admitted to hospital, and the percentage was even higher – 73.08% – among African American patients, compared to 53.85% of Caucasians with the two positions.
- The overall risk of death for patients with COVID-19 was 5.64%. But among those with dementia as well, 20.99% died, with the percentage higher for African Americans (23.08%) than for Caucasians (19.23%).
This work was supported by the National Institutes of Health National Institute on Aging (grant numbers AG057557, AG061388, AG062272) and the National Center for the Advancement of Translational Sciences (grant numberUL1TR002548-01).