Collision of Alzheimers disease and COVID-19 pandemic in the United States: risks, outcomes, disparities and treatments

项目摘要 在这个名为“阿尔茨海默病和COVID-19大流行在美国的碰撞： 风险、结果、差异和治疗”，我们建议：1）检查患有以下疾病的患者的COVID-19风险： 阿尔茨海默氏病（AD），考虑种族和性别差异，并随着时间的推移跟踪其演变; 2）检查 在COVID-19幸存者中新发AD，考虑种族和性别差异，并跟踪这些变化 时间; 3）描述COVID-19的长程神经精神性急性后遗症（Neuro-PASC）， 19名AD幸存者，考虑种族和性别差异，并随着时间的推移跟踪这些变化;以及4） 研究肿瘤坏死因子（TNF）阻滞剂对总死亡率和长期生存率的治疗作用 患有AD的COVID-19幸存者的Neuro-PASC。为了回答这些问题，我们将利用一个全国性的，真实的- 8000万名患者（480万名确诊患者）的去识别电子健康记录（EHR）的时间数据库 COVID-19病例）。我们的研究将主要集中在超过1700万年龄≥ 65岁的老年患者，包括 超过100万例COVID-19病例，265，818例确诊为AD患者，22，518例同时患有AD和AD COVID-19和AD（截至2021年5月20日）。我们的研究将建立实时分析EHR的方法， 美国数千万脆弱的老龄人口在检查传染病和他们的 与现有的疾病，如AD的相互作用，这将使我们能够更好地准备，如果另一个 流行病袭击了我们。因此，这些研究的意义超出了手头的数据。

PROJECT SUMMARY In this project titled “Collision of Alzheimer’s disease and COVID-19 pandemic in the United States: risks, outcomes, disparities and treatments”, we propose to: 1) examine COVID-19 risk in patients with Alzheimer’s disease (AD), consider racial and gender disparity, and follow its evolution over time; 2) examine new onset of AD in COVID-19 survivors, consider racial and gender disparity, and follow these changes over time; 3) characterize long-haul neuropsychiatric Post-Acute Sequelae of COVID-19 (Neuro-PASC) in COVID- 19 survivors with AD, consider racial and gender disparity, and follow these changes over time; and 4) investigate therapeutic effects of Tumor Necrosis Factor (TNF) blockers on overall mortality and long-haul Neuro-PASC in COVID-19 survivors with AD. To answer these questions, we will utilize a US nation-wide, real- time database of de-identified electronic health records (EHRs) of 80 million patients (4.8 million confirmed COVID-19 cases). Our study will primarily focus on over 17 million senior patients age ³ 65 years, including more than 1 million COVID-19 cases, 265,818 patients diagnosed with AD, and 22,518 patients with both COVID-19 and AD (as of May 20, 2021). Our study will establish methods for real-time analysis of EHRs of vulnerable aging population of tens of millions across the USA in examining infectious diseases and their interaction with existing disorders such as AD, which will allow us to be better prepared should another pandemic overtake us. The significance of these studies therefore extends beyond the data at hand.