Neurodegenerative Diseases Tied to COVID-19 Infection, Mortality Risk

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In a cohort analysis in the UK biobank, researchers assessed the association between individuals with previous neurodegenerative diseases and the subsequent risk for COVID-19.

Patients with a previous neurodegenerative disease have an increased risk for COVID-19, including COVID-19–related hospitalization and mortality, according to a study published in BMC Neurology.

During the COVID-19 pandemic, patients with neurodegenerative diseases are considered to be a high-risk population due to their advanced age and the presence of other comorbidities. Self-isolation and social distancing due to COVID-19 may also have an influence in this patient population, the researchers stated. Previous research has investigated the association between neurodegenerative diseases and COVID-19, but the findings have been inconclusive because of factors like different study design.

The objective of the current study was to assess individuals with previous neurodegenerative diseases, such as primary and vascular neurodegenerative diseases, and their susceptibility to COVID-19.

The researchers conducted a cohort analysis of 96,275 participants from the UK Biobank with at least 1 positive test for SARS-CoV-2 before June 14, 2021. Patients who had an inpatient admission record of any neurodegenerative disease before January 31, 2020, were included in the exposed group, with the remaining participants comprising the unexposed group.

Of the cohort, 2617 (2.7%) had a pre-pandemic diagnosis of neurodegenerative disease. The overall mean age of participants at the COVID-19 outbreak was 67.9 years, 46.4% were male, and 89.7% were White.

A total of 17,938 individuals were diagnosed with COVID-19, including 5749 with inpatient COVID-19 and 1181 with COVID-19–related death as of June 14, 2021. The researchers found an increased risk of COVID-19 (27.4% vs 18.4%), inpatient COVID-19 (14.5% vs 5.7%), and COVID-19–related death (7.5% vs 1.1%) in participants with neurodegenerative disease vs the unexposed participants, respectively.

The fully adjusted odds ratio (OR) was 2.47 (95% CI, 2.25-2.71) for COVID-19, 2.18 (95% CI, 1.94-2.45) for inpatient COVID-19, and 3.67 (95% CI, 3.11-4.34) for COVID-19–related death after adjustment for all available confounders.

Regarding subtypes of neurodegenerative diseases, the increased risk for COVID-19 was greater for vascular neurodegenerative diseases vs primary neurodegenerative diseases (OR 4.79 [95% CI, 3.84-5.97] vs OR 2.17 [95% CI, 1.95-2.41], respectively; P value for difference <.001).

Among the patients who tested positive for COVID-19, an increased risk for COVID-19–related death was found in those with neurodegenerative diseases (fully adjusted OR 2.08; 95% CI, 1.71-2.53).

Sensitivity analysis with a matched cohort design revealed similar results to the main analysis. The fully adjusted OR was 2.17 (95% CI, 1.96-2.41) for COVID-19, 2.17 (95% CI, 1.89-2.48) for inpatient COVID-19, and 3.90 (95% CI, 3.17-4.79) for COVID-19–related death.

The researchers noted several study limitations. Patients with neurodegenerative diseases may have different access to health care and to COVID-19 testing. Also, information was lacking on place of residence such as care homes. In addition, somatic comorbidities were measured by diagnoses from inpatient hospital data, and UK Biobank participants are not representative of the general population in the UK.

“Although validations from future studies are needed, these findings underscore the need for better surveillance and medical care for individuals with neurodegenerative diseases during the COVID-19 outbreak, both before and after contracting the infection,” the researchers concluded.

Reference

Hu Y, Yang H, Hou C, et al. COVID-19 related outcomes among individuals with neurodegenerative diseases: a cohort analysis in the UK biobank. BMC Neurol. Published online January 7, 2022. doi: 10.1186/s12883-021-02536-7