Psychotropic Medication Use Is Associated With Greater 1-Year Incidence of Dementia After COVID-19 Hospitalization.
Psychotropic Medication Use Is Associated With Greater 1-Year Incidence of Dementia After COVID-19 Hospitalization.
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精神药物的使用与COVID-19-19 HOSIPAIDE后的痴呆症发生率更高有关。
DOI：
10.3389/fmed.2022.841326
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发表时间：
2022
影响因子：
3.9
通讯作者：
Sinvani L
中科院分区：
文献类型：
--
作者：
Freudenberg-Hua Y;Makhnevich A;Li W;Liu Y;Qiu M;Marziliano A;Carney M;Greenwald B;Kane JM;Diefenbach M;Burns E;Koppel J;Sinvani L
COVID-19与发生痴呆（COVID-19后痴呆）的风险增加有关。建立额外的风险标记可能有助于识别有风险的个体并指导临床决策。我们调查了1755例（≥65岁）住院的COVID-19患者在COVID-19前的精神药物使用（暴露）和1年痴呆发生率（结局）。Logistic回归模型用于检验相关性，调整人口统计学和临床变量。为了进一步确认，我们应用了最小绝对收缩和选择算子（LASSO）回归和机器学习（随机森林）算法。新冠肺炎后痴呆1年发病率为12.7% （N = 223）。冠状病毒病前精神药物（OR = 2.7, 95% CI: 1.8-4.0, P < 0.001）和谵妄（OR = 3.0, 95% CI: 1.9-4.6, P < 0.001）与冠状病毒病后1年痴呆发生率升高显著相关。当分析仅限于423名在入院时至少有一项记录的神经或精神诊断的患者时，精神药物与痴呆发生率之间的关联仍然很强（or = 3.09, 95% CI: 1.5-6.6, P = 0.002）。在不同的药物类别中，抗精神病药（OR = 2.8, 95% CI: 1.7-4.4, P < 0.001）和情绪稳定剂/抗惊厥药（OR = 2.4, 95% CI: 1.39-4.02, P = 0.001）与新冠肺炎后痴呆的相关性最大。随机森林和LASSO分析进一步证实了精神药物与痴呆的关联。证实先前的研究，我们观察到老年患者在COVID-19住院后痴呆发病率高。covid - 19前精神药物与更高的痴呆发生率相关。精神药物可能是表明前驱痴呆期间神经精神症状的风险标志物，而不是相互排斥，有助于后covid痴呆。
COVID-19 has been associated with an increased risk of incident dementia (post-COVID dementia). Establishing additional risk markers may help identify at-risk individuals and guide clinical decision-making. We investigated pre-COVID psychotropic medication use (exposure) and 1-year incidence of dementia (outcome) in 1,755 patients (≥65 years) hospitalized with COVID-19. Logistic regression models were used to examine the association, adjusting for demographic and clinical variables. For further confirmation, we applied the Least Absolute Shrinkage and Selection Operator (LASSO) regression and a machine learning (Random Forest) algorithm. One-year incidence rate of post-COVID dementia was 12.7% (N = 223). Pre-COVID psychotropic medications (OR = 2.7, 95% CI: 1.8–4.0, P < 0.001) and delirium (OR = 3.0, 95% CI: 1.9–4.6, P < 0.001) were significantly associated with greater 1-year incidence of post-COVID dementia. The association between psychotropic medications and incident dementia remained robust when the analysis was restricted to the 423 patients with at least one documented neurological or psychiatric diagnosis at the time of COVID-19 admission (OR = 3.09, 95% CI: 1.5–6.6, P = 0.002). Across different drug classes, antipsychotics (OR = 2.8, 95% CI: 1.7–4.4, P < 0.001) and mood stabilizers/anticonvulsants (OR = 2.4, 95% CI: 1.39–4.02, P = 0.001) displayed the greatest association with post-COVID dementia. The association of psychotropic medication with dementia was further confirmed with Random Forest and LASSO analysis. Confirming prior studies we observed a high dementia incidence in older patients after COVID-19 hospitalization. Pre-COVID psychotropic medications were associated with higher risk of incident dementia. Psychotropic medications may be risk markers that signify neuropsychiatric symptoms during prodromal dementia, and not mutually exclusive, contribute to post-COVID dementia.
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影响因子：
7.8
作者：
Lin, Ching-En;Chung, Chi-Hsiang;Chi, Mei-Ju
通讯作者：
Chi, Mei-Ju
DOI：
10.1126/science.abe9403
发表时间：
2020-12-04
期刊：
Science (New York, N.Y.)
影响因子：
--
作者：
Gordon DE;Hiatt J;Bouhaddou M;Rezelj VV;Ulferts S;Braberg H;Jureka AS;Obernier K;Guo JZ;Batra J;Kaake RM;Weckstein AR;Owens TW;Gupta M;Pourmal S;Titus EW;Cakir M;Soucheray M;McGregor M;Cakir Z;Jang G;O'Meara MJ;Tummino TA;Zhang Z;Foussard H;Rojc A;Zhou Y;Kuchenov D;Hüttenhain R;Xu J;Eckhardt M;Swaney DL;Fabius JM;Ummadi M;Tutuncuoglu B;Rathore U;Modak M;Haas P;Haas KM;Naing ZZC;Pulido EH;Shi Y;Barrio-Hernandez I;Memon D;Petsalaki E;Dunham A;Marrero MC;Burke D;Koh C;Vallet T;Silvas JA;Azumaya CM;Billesbølle C;Brilot AF;Campbell MG;Diallo A;Dickinson MS;Diwanji D;Herrera N;Hoppe N;Kratochvil HT;Liu Y;Merz GE;Moritz M;Nguyen HC;Nowotny C;Puchades C;Rizo AN;Schulze-Gahmen U;Smith AM;Sun M;Young ID;Zhao J;Asarnow D;Biel J;Bowen A;Braxton JR;Chen J;Chio CM;Chio US;Deshpande I;Doan L;Faust B;Flores S;Jin M;Kim K;Lam VL;Li F;Li J;Li YL;Li Y;Liu X;Lo M;Lopez KE;Melo AA;Moss FR 3rd;Nguyen P;Paulino J;Pawar KI;Peters JK;Pospiech TH Jr;Safari M;Sangwan S;Schaefer K;Thomas PV;Thwin AC;Trenker R;Tse E;Tsui TKM;Wang F;Whitis N;Yu Z;Zhang K;Zhang Y;Zhou F;Saltzberg D;QCRG Structural Biology Consortium;Hodder AJ;Shun-Shion AS;Williams DM;White KM;Rosales R;Kehrer T;Miorin L;Moreno E;Patel AH;Rihn S;Khalid MM;Vallejo-Gracia A;Fozouni P;Simoneau CR;Roth TL;Wu D;Karim MA;Ghoussaini M;Dunham I;Berardi F;Weigang S;Chazal M;Park J;Logue J;McGrath M;Weston S;Haupt R;Hastie CJ;Elliott M;Brown F;Burness KA;Reid E;Dorward M;Johnson C;Wilkinson SG;Geyer A;Giesel DM;Baillie C;Raggett S;Leech H;Toth R;Goodman N;Keough KC;Lind AL;Zoonomia Consortium;Klesh RJ;Hemphill KR;Carlson-Stevermer J;Oki J;Holden K;Maures T;Pollard KS;Sali A;Agard DA;Cheng Y;Fraser JS;Frost A;Jura N;Kortemme T;Manglik A;Southworth DR;Stroud RM;Alessi DR;Davies P;Frieman MB;Ideker T;Abate C;Jouvenet N;Kochs G;Shoichet B;Ott M;Palmarini M;Shokat KM;García-Sastre A;Rassen JA;Grosse R;Rosenberg OS;Verba KA;Basler CF;Vignuzzi M;Peden AA;Beltrao P;Krogan NJ
通讯作者：
Krogan NJ
DOI：
10.1136/bmj.d4551
发表时间：
2011-08-02
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Coupland C;Dhiman P;Morriss R;Arthur A;Barton G;Hippisley-Cox J
通讯作者：
Hippisley-Cox J
影响因子：
64.8
作者：
Al-Aly, Ziyad;Xie, Yan;Bowe, Benjamin
通讯作者：
Bowe, Benjamin
DOI：
10.1093/jamia/ocw021
发表时间：
2016-11-01
影响因子：
6.4
作者：
Madden, Jeanne M.;Lakoma, Matthew D.;Soumerai, Stephen B.
通讯作者：
Soumerai, Stephen B.