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

项目概要 在这个题为“美国阿尔茨海默病与 COVID-19 大流行的碰撞”的项目中： 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： 阿尔茨海默病 (AD)，考虑种族和性别差异，并跟踪其随时间的演变； 2）检查 COVID-19 幸存者中 AD 新发，考虑种族和性别差异，并跟踪这些变化 时间； 3) 描述 COVID-19 中长期神经精神急性后遗症 (Neuro-PASC) 的特征 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；和 4) 研究肿瘤坏死因子 (TNF) 阻滞剂对总体死亡率和长期死亡率的治疗效果 患有 AD 的 COVID-19 幸存者中的 Neuro-PASC。为了回答这些问题，我们将利用美国全国范围内的、真实的 8000 万患者（480 万已确诊患者）的去识别化电子健康记录 (EHR) 时间数据库 COVID-19 病例）。我们的研究将主要关注超过 1700 万年龄 65 岁以上的老年患者，包括 超过 100 万例 COVID-19 病例，265,818 名患者被诊断患有 AD，以及 22,518 名患者同时患有 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电子病历的方法 美国各地数以千万计的弱势老龄人口正在检查传染病及其影响 与 AD 等现有疾病的相互作用，这将使我们能够更好地准备 大流行病压倒了我们。因此，这些研究的意义超出了现有数据的范围。

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.