ABSTRACT
Objective: to analyse the frequency of cognitive impairment and other neurological comorbidities in deceased COVID-19 patients, during the outbreak of the pandemic in Madrid, Spain. Methods: retrospective, single-center, hospital-based study. We included adults that died after admission from March 1 to March 31, 2020, at Hospital Universitario 12 De Octubre. Clinical and demographic data were extracted from electronic medical records. Results: 477 cases: 58 with probable COVID-19, 281 confirmed COVID-19, and 138 who died of other causes. Comparing the latter two groups, median age (81.4 years vs. 78.1 years;p<0.01) and the proportion of males (62.3% vs. 49.3%, p<0.01) were higher in the confirmed COVID-19 group. The number of comorbidities was high and similar in both groups, and cognitive impairment was common (29.9%;21.1% dementia;8.9% mild cognitive impairment) in confirmed COVID-19. In this group group, subjects with cognitive impairment were older (median 85.8 years vs. 79.0 years, p<0.0001), more lived in nursing homes and had slightly shorter times from symptom onset to death than those without cognitive impairment. COVID-19 patients with cognitive impairment were rarely admitted to the ICU, and fewer received non-invasive mechanical ventilation (7.1% vs. 25.4%, <0.0001). Palliative care was provided in more subjects with cognitive impairment (79.2% vs. 66.3%, p=0.038). Conclusions: in our study, dead patients with confirmed COVID-19 were older and had more comorbidities than those reported in the Asian population. Cognitive impairment is a frequent comorbidity in COVID-19 deceased patients. The burden of COVID-19 in the dementia community will be high.