ABSTRACT
Introducción La población anciana es la más amenazada por COVID-19, con mayores tasas de mortalidad. El objetivo de este trabajo es analizar la letalidad en una cohorte de pacientes de COVID-19 con demencia degenerativa. Métodos Hicimos un estudio descriptivo de casos-control de una muestra de pacientes diagnosticados con demencias neurodegenerativas primarias. Resultados De los 88 pacientes incluidos en el estudio, 24 pacientes con COVID-19 fallecieron: 10/23 (43,4%) eran pacientes con diagnóstico de demencia y 14/65 (21,5%) pacientes del grupo control, una diferencia estadísticamente significativa. Discusión La letalidad por COVID-19 entre los pacientes con demencia degenerativa primaria es significativamente mayor en comparación con otros pacientes con edades medias y comorbilidades similares, según nuestro estudio.
Subject(s)
Betacoronavirus , Coronavirus Infections , Hospital Units/organization & administration , Neurology/organization & administration , Pandemics , Pneumonia, Viral , Telemedicine/organization & administration , COVID-19 , Cost Savings , Diagnosis-Related Groups , Hospital Units/economics , Humans , Neurology/economics , Neuromuscular Diseases/therapy , SARS-CoV-2 , Spain , Telemedicine/economicsABSTRACT
INTRODUCTION The elderly population is the group most threatened by COVID-19, with the highest mortality rates. This study aims to analyse the case fatality of COVID-19 in a cohort of patients with degenerative dementia. METHODS We conducted a descriptive case-control study of a sample of patients diagnosed with primary neurodegenerative dementia. RESULTS Twenty-four of the 88 patients with COVID-19 included in the study died: 10/23 (43.4%) patients diagnosed with dementia and 14/65 (21.5%) controls;this difference was statistically significant. DISCUSSION Our results suggest that case fatality of COVID-19 is significantly higher among patients with primary degenerative dementia than in other patients with similar mean ages and comorbidities. Resumen INTRODUCCIÓN La población anciana es la más amenazada por COVID-19, con mayores tasas de mortalidad. El objetivo de este trabajo es analizar la letalidad en una cohorte de pacientes de COVID-19 con demencia degenerativa. MÉTODOS Hicimos un estudio descriptivo de casos-control de una muestra de pacientes diagnosticados con demencias neurodegenerativas primarias. RESULTADOS De los 88 pacientes incluidos en el estudio, 24 pacientes con COVID-19 fallecieron: 10/23 (43,4%) eran pacientes con diagnóstico de demencia y 14/65 (21,5%) pacientes del grupo control, una diferencia estadísticamente significativa. DISCUSIÓN La letalidad entre los pacientes con demencia degenerativa primaria por COVID-19 es significativamente mayor en comparación con otros pacientes con edades medias y comorbilidades similares, según nuestro estudio.
ABSTRACT
INTRODUCTION: The elderly population is the group most threatened by COVID-19, with the highest mortality rates. This study aims to analyse the case fatality of COVID-19 in a cohort of patients with degenerative dementia. METHODS: We conducted a descriptive case-control study of a sample of patients diagnosed with primary neurodegenerative dementia. RESULTS: Twenty-four of the 88 patients with COVID-19 included in the study died: 10/23 (43.4%) patients diagnosed with dementia and 14/65 (21.5%) controls; this difference was statistically significant. DISCUSSION: Our results suggest that case fatality of COVID-19 is significantly higher among patients with primary degenerative dementia than in other patients with similar mean ages and comorbidities.
Subject(s)
Betacoronavirus , Coronavirus Infections/mortality , Dementia/epidemiology , Neurodegenerative Diseases/epidemiology , Pandemics , Pneumonia, Viral/mortality , Aged , Aged, 80 and over , Alzheimer Disease/epidemiology , COVID-19 , Cardiovascular Diseases/epidemiology , Case-Control Studies , Comorbidity , Diabetes Mellitus/epidemiology , Female , Humans , Kidney Diseases/epidemiology , Lung Diseases/epidemiology , Male , Prevalence , Risk Factors , SARS-CoV-2 , Smoking/epidemiology , Spain/epidemiologyABSTRACT
INTRODUCTION: The COVID-19 pandemic will give rise to long-term changes in neurological care, which are not easily predictable. MATERIAL AND METHODS: A key informant survey was used to enquire about the changes expected in the specialty over the next 5 years. The survey was completed by heads of neurology departments with broad knowledge of the situation, having been active during the pandemic. RESULTS: Despite a low level of consensus between participants, there was strong (85%) and moderate consensus (70%) about certain subjects, mainly the increase in precautions to be taken, the use of telemedicine and teleconsultations, the reduction of care provided in in-person consultations to avoid the presence of large numbers of people in waiting rooms, the development of remote training solutions, and the changes in monitoring visits during clinical trials. There was consensus that there would be no changes to the indication of complementary testing or neurological examination. CONCLUSION: The key informant survey identified the foreseeable changes in neurological care after the pandemic.
Subject(s)
Coronavirus Infections , Health Care Surveys , Nervous System Diseases/therapy , Neurology/trends , Pandemics , Pneumonia, Viral , Administrative Personnel/psychology , COVID-19 , COVID-19 Testing , Clinical Laboratory Techniques , Clinical Trials as Topic/methods , Consensus , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Disease Management , Distance Counseling , Forecasting , Hospital Departments/organization & administration , Humans , Nervous System Diseases/diagnosis , Neurologic Examination , Neurology/methods , Neurology/organization & administration , Pandemics/prevention & control , Patient Isolation , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Spain/epidemiologyABSTRACT
INTRODUCTION: On March 11th, 2020, the WHO declared the SARS-Cov-2 pandemic. Syndromes have been detected in relation to COVID-19 such as encephalitis, acute necrotizing hemorrhagic encephalopathy and cerebrovascular complications. There are also cases of peripheral nervous system involvement. METHODS: Our case would be the 3rd patient with MFS associated with COVID-19 as far as we know. RESULTS: We present a 51 years old female diagnosed with MFS two weeks after COVID-19. RTPCR to SARS-CoV-2 was negative but IgG was positive. CONCLUSION: Most of the cases were mild or moderate with typical signs and symptoms. All were treated with IV immunoglobulin with good response in most cases. Despite the short evolution time of the cases surviving the current pandemic, the description of cases of post-infectious neurological syndromes suggests that this is probably not an infrequent complication in the subacute stage of Covid-19 disease.
Subject(s)
COVID-19/complications , Miller Fisher Syndrome/etiology , Female , Humans , Immunoglobulins, Intravenous , Middle Aged , Miller Fisher Syndrome/drug therapy , Treatment OutcomeABSTRACT
INTRODUCTION: SARS-CoV-2 was first detected in December 2019 in the Chinese city of Wuhan and has since spread across the world. At present, the virus has infected over 1.7 million people and caused over 100 000 deaths worldwide. Research is currently focused on understanding the acute infection and developing effective treatment strategies. In view of the magnitude of the epidemic, we conducted a speculative review of possible medium- and long-term neurological consequences of SARS-CoV-2 infection, with particular emphasis on neurodegenerative and neuropsychiatric diseases of neuroinflammatory origin, based on the available evidence on neurological symptoms of acute SARS-CoV-2 infection. DEVELOPMENT: We systematically reviewed the available evidence about the pathogenic mechanisms of SARS-CoV-2 infection, the immediate and lasting effects of the cytokine storm on the central nervous system, and the consequences of neuroinflammation for the central nervous system. CONCLUSIONS: SARS-CoV-2 is a neuroinvasive virus capable of triggering a cytokine storm, with persistent effects in specific populations. Although our hypothesis is highly speculative, the impact of SARS-CoV-2 infection on the onset and progression of neurodegenerative and neuropsychiatric diseases of neuroinflammatory origin should be regarded as the potential cause of a delayed pandemic that may have a major public health impact in the medium to long term. Cognitive and neuropsychological function should be closely monitored in COVID-19 survivors.