COVID-19 related outcomes among individuals with neurodegenerative diseases: a cohort analysis in the UK biobank

Yihan Hu,Fang Fang,Can Hou,Hanyue Zhang,Yao Hu,Yuanyuan Qu,Maria Feychting,Yajing Sun,Zhiye Ying,Unnur Valdimarsdottir,Huan Song,Huazhen Yang,Wenwen Chen

doi:10.1186/s12883-021-02536-7

Yihan Hu, Fang Fang + Show 11 more

Open Access

https://doi.org/10.1186/s12883-021-02536-7

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Abstract

BackgroundAn increased susceptibility to COVID-19 has been suggested for individuals with neurodegenerative diseases, but data are scarce from longitudinal studies.MethodsIn this community-based cohort study, we included 96,275 participants of the UK Biobank who had available SARS-CoV-2 test results in Public Health England. Of these, 2617 had a clinical diagnosis of neurodegenerative diseases in the UK Biobank inpatient hospital data before the outbreak of COVID-19 (defined as January 31st, 2020), while the remaining participants constituted the reference group. We then followed both groups from January 31st, 2020 to June 14th, 2021 for ascertainment of COVID-19 outcomes, including any COVID-19, inpatient care for COVID-19, and COVID-19 related death. Logistic regression was applied to estimate the association between neurogenerative disease and risks of COVID-19 outcomes, adjusted for multiple confounders and somatic comorbidities.ResultsWe observed an elevated risk of COVID-19 outcomes among individuals with a neurodegenerative disease compared with the reference group, corresponding to a fully adjusted odds ratio of 2.47 (95%CI 2.25–2.71) for any COVID-19, 2.18 (95%CI 1.94–2.45) for inpatient COVID-19, and 3.67 (95%CI 3.11–4.34) for COVID-19 related death. Among individuals with a positive test result for SARS-CoV-2, individuals with neurodegenerative diseases had also a higher risk of COVID-19 related death than others (fully adjusted odds ratio 2.08; 95%CI 1.71–2.53).ConclusionAmong UK Biobank participants who received at least one test for SARS-CoV-2, a pre-existing diagnosis of neurodegenerative disease was associated with a subsequently increased risk of COVID-19, especially COVID-19 related death.

Highlights

An increased susceptibility to COVID-19 has been suggested for individuals with neurodegenerative diseases, but data are scarce from longitudinal studies
Among the 96,275 participants included in the analysis, 2617 (2.7%) had a pre-pandemic diagnosis of neurodegenerative disease with the other 93,658 (97.3%) included in the unexposed group (Fig. 1)
We observed an elevated risk of any COVID-19 (27.4% vs 18.4%), inpatient COVID19 (14.5% vs 5.7%), and COVID-19 related death (7.5% vs 1.1%) among individuals with neurodegenerative disease compared with the unexposed individuals (Table 1)

Summary

Introduction

An increased susceptibility to COVID-19 has been suggested for individuals with neurodegenerative diseases, but data are scarce from longitudinal studies. Most individuals contracted with COVID-19 experience rather mild symptoms [2], elderly people and individuals with chronic diseases are more prone to experience a severe disease course [3,4,5,6]. With the early death of dopaminergic neurons, Parkinson’s disease (PD) mainly affects the motor system, leading to movement disorders typically presented as rest tremor, rigidity, bradykinesia, postural, and gait impairment [9]. Individuals with neurodegenerative diseases are a high-risk population during the COVID-19 pandemic, because of their advanced age and presence of other comorbidities [10,11,12]. Self-isolation and social distancing due to COVID-19 may have further influence on individuals living with neurodegenerative diseases [13]

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