ABSTRACT
SESSION TITLE: COVID-19: Other Considerations in Management SESSION TYPE: Original Investigations PRESENTED ON: 10/18/2022 02:45 pm - 03:45 pm PURPOSE: In the context of COVID-19, dementia is a well-established risk factor for COVID-19 mortality compared to patients without dementia. To the date, however, there is limited understanding on how a preexisting dementia diagnosis may impact time to death following COVID-19 infection. Of note, identification of risk factors for earlier versus later mortality has the potential to influence treatment and hospice care decisions. Therefore, our aim was to investigate if Veterans with preexisting dementia experienced a longer time from COVID-19 diagnosis to death (all-cause mortality) compared to those without dementia who died of COVID-19. METHODS: We conducted a retrospective, cross-sectional chart review study utilizing data collected at the South Texas Veteran Health Care System from April 2020 to December 2021. Participants comprised deceased Veterans from all-cause mortality following COVID-19 infection, both with and without a preexisting dementia diagnosis in the 5 years prior to COVID-19 diagnosis. We conducted a univariate analysis of covariance, controlling for patient age, to investigate if days from COVID-19 diagnosis to death differed between patients with and without a preexisting dementia diagnosis. RESULTS: A total of N= 382 deceased subjects from all-cause mortality infected with COVID-19 were found in our data base, with a mean age of 73.74 years (SD = 12.33). The majority (64.65%;n = 247) did not have dementia, while 35 % (n = 135) had a preexisting dementia diagnosis in their medical record. Results indicated that number of days from COVID-19 diagnosis to death did not differ (F(1, 379) = 0.02, p = ns) between deceased subjects with dementia (M = 74.6 days, SD = 81.0) and without dementia (M = 75.6, SD = 93.6), controlling for patient age. Patient age was nonsignificant in the model (F(1,379) = 0.44, p = ns). CONCLUSIONS: Among patients deceased for all-cause mortality with COVID-19 infection, results did not indicate a significant difference in time to death following COVID-19 diagnosis between patients with preexisting dementia or without, controlling for age. Although dementia is an established risk factor for COVID-19 related death, it is likely one piece of a complex puzzle in terms of predicting earlier versus later mortality. Future research is needed to identify potential moderators of illness trajectory prior to death among patients following a COVID-19 diagnosis. CLINICAL IMPLICATIONS: Further studies are needed on this field. Limitations of our study were abscense of subgroups for different severity dementia classification, the diagnosis of COVD-19 for our data base was made based on the day an ICD code was entered on the subject’s chart, rather than physician diagnosis, patient’s symptoms starting day, or previous outside COVID-19 tests. Moreover, we didn’t account for other comorbidities, and most patients were male. DISCLOSURES: No relevant relationships by Lisa Kilpela No relevant relationships by Michael Mader No relevant relationships by Onachi Ofoma No relevant relationships by Carlos Perez Ruiz No relevant relationships by Marcos Restrepo No relevant relationships by Sandra Sanchez-Reilly