Cognitive concerns are a risk factor for mortality in people with HIV and coronavirus disease 2019.
AIDS
; 37(10): 1565-1571, 2023 08 01.
Article
em En
| MEDLINE
| ID: mdl-37195278
ABSTRACT
BACKGROUND:
Data supporting dementia as a risk factor for coronavirus disease 2019 (COVID-19) mortality relied on ICD-10 codes, yet nearly 40% of individuals with probable dementia lack a formal diagnosis. Dementia coding is not well established for people with HIV (PWH), and its reliance may affect risk assessment.METHODS:
This retrospective cohort analysis of PWH with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) PCR positivity includes comparisons to people without HIV (PWoH), matched by age, sex, race, and zipcode. Primary exposures were dementia diagnosis, by International Classification of Diseases (ICD)-10 codes, and cognitive concerns, defined as possible cognitive impairment up to 12âmonths before COVID-19 diagnosis after clinical review of notes from the electronic health record. Logistic regression models assessed the effect of dementia and cognitive concerns on odds of death [odds ratio (OR); 95% CI (95% confidence interval)]; models adjusted for VACS Index 2.0.RESULTS:
Sixty-four PWH were identified out of 14â129 patients with SARS-CoV-2 infection and matched to 463 PWoH. Compared with PWoH, PWH had a higher prevalence of dementia (15.6% vs. 6%, P â=â0.01) and cognitive concerns (21.9% vs. 15.8%, P â=â0.04). Death was more frequent in PWH ( P â<â0.01). Adjusted for VACS Index 2.0, dementia [2.4 (1.0-5.8), P â=â0.05] and cognitive concerns [2.4 (1.1-5.3), P â=â0.03] were associated with increased odds of death. In PWH, the association between cognitive concern and death trended towards statistical significance [3.92 (0.81-20.19), P â=â0.09]; there was no association with dementia.CONCLUSION:
Cognitive status assessments are important for care in COVID-19, especially among PWH. Larger studies should validate findings and determine long-term COVID-19 consequences in PWH with preexisting cognitive deficits.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Infecções por HIV
/
Demência
/
COVID-19
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article