Characteristics and mortality of geriatric patients infected with Sars-CoV2: Description and comparison of patients hospitalized in a dedicated COVID unit and those in an Alzheimer's unit

Introduction: By July 1st, 2020, the SARS-CoV2 epidemic had affected more than 200 countries with more than 10 million identified cases and 508,000 deaths. Many older people have been infected, but little data exists for those aged over 75 years, especially for those presenting cognitive and behavioral problems. Objective: To describe the characteristics of the symptoms presented by two populations of hospitalized patients: patients hospitalized in an “Alzheimer's” protected unit and “standard” patients hospitalized in a dedicated COVID unit, and to compare the mortality rates. Materials and method: A retrospective study including patients over 65 years old hospitalized in Paul-Brousse was conducted from March 13 to April 15, 2020 in an Alzheimer's unit and a COVID unit, with Sars-CoV2 infection confirmed by RT-PCR or serology. Data was derived from medical records concerning the patient's background, long-term treatments, and clinical and laboratory data during the infection. Results: One hundred and seventy-eight patients (87 years [82;91], 67% women) were included, including 60 “Alzheimer” patients (86 years [81;88.25], 68% women) and 118 “standard” patients (88 years [83.25;92], 66% female). The “standard” group was older and had a higher Charlson comorbidity index. The mortality rate was not significantly different between the 2 groups (P = 0.09). Clinically, the “standard” group had a more serious infection than the “Alzheimer's” group: the qSOFA score and the maximum oxygen flow required were higher. Also, biologically, the “standard” group had more marked lymphopenia and eosinopenia. On the other hand, patients in the “Alzheimer” group were significantly more often receiving neuroleptics. Conclusion: The mortality rate was the same among patients in the Alzheimer's unit and in the Covid unit, with however a tendency to register more deaths in the “standard” group (27% vs. 17%, P = 0.09). A more powerful study would be needed to assess the possible protective role of neuroleptics. © 2021 Elsevier Masson SAS Introduction: Au premier juillet 2020, l’epidemie de SARS-CoV2 avait concerne plus de 200 pays, infecte 10 millions de personnes et etait la cause de 508 000 deces dans le monde. Peu de donnees existent concernant les plus de 75 ans, notamment lorsqu'ils ont des troubles cognitifs et du comportement. Objectif: Presenter les caracteristiques des symptomes observes dans deux populations de patients hospitalises : les patients en unites protegees « Alzheimer » et les patients « standards » hospitalises en unite dediee COVID, et comparer les taux de mortalite. Materiel et methode: Etude retrospective incluant les patients de plus de 65 ans hospitalises a Paul-Brousse du 13 mars au 15 avril 2020 en unite Alzheimer et en unite COVID, et ayant une infection au Sars-CoV2 confirmee par RT-PCR ou serologie. Recueil de donnees a partir des dossiers medicaux concernant le terrain du patient, les traitements pris au long cours, les donnees cliniques et biologiques pendant l'infection. Resultats: Cent soixante-dix-huit patients (87 ans [82;91], 67 % de femmes) ont ete inclus dont 60 patients « Alzheimer » (86 ans [81;88,25], 68 % de femmes) et 118 patients « standards » (88 ans [83,25;92], 66 % de femmes). Le groupe standard etait plus âge et avait un score de Charlson plus eleve. Le taux de mortalite n’etait pas significativement different entre les 2 groupes (p = 0,09). Cliniquement, le groupe « standard » presentait une infection plus grave que le groupe « Alzheimer » : le score qSOFA et le debit d'oxygene maximum necessaire etaient plus eleves. De meme, biologiquement, le groupe « standard » presentait une lymphopenie non observee dans le groupe « Alzheimer ». En revanche, les patients du groupe « Alzheimer » consommaient significativement plus de neuroleptiques. Conclusion: Le taux de mortalite etait le meme chez les patients en unites Alzheimer et en unite COVID, avec cependant une tendance a y avoir plus de deces dans le groupe « standard » (27 % vs 17 %, p = 0,09). Une etude plus puissante serait necessaire pou evaluer l’eventuel role protecteur des neuroleptiques. © 2021 Elsevier Masson SAS