Caractéristiques et mortalité des patients gériatriques infectés au Sars-CoV2 : description et comparaison des patients hospitalisés en unité dédiée COVID et de ceux en unités Alzheimer

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.