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Donepezil-associated survival benefits among Alzheimer's disease patients are retained but not enhanced during COVID-19 infections.

Edmiston EA, Bej TA, Wilson B, Jump RLP, Phillips JA. Donepezil-associated survival benefits among Alzheimer's disease patients are retained but not enhanced during COVID-19 infections. Therapeutic advances in infectious disease. 2023 May 22; 10:20499361231174289.

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Abstract:

BACKGROUND AND AIM: Donepezil is a front-line treatment for Alzheimer''s disease. Donepezil treatment is associated with decreased risk of all-cause mortality. Specific protection is observed in pneumonia and cardiovascular disease. We hypothesized that donepezil treatment would improve mortality among Alzheimer''s patients following infection with COVID-19. The objective of this study is to assess the influence of ongoing donepezil treatment on survival in Alzheimer''s disease patients after polymerase chain reaction (PCR)-confirmed COVID-19 infection. METHODS: This is a retrospective cohort study. We conducted a national survey of Veterans with Alzheimer''s disease to assess the influence of ongoing donepezil treatment on survival in Alzheimer''s disease patients after PCR-confirmed COVID-19 infection. We assessed all-cause 30-day mortality stratified by COVID-19 infection and donepezil use, estimating odds ratios using multivariate logistic regression. RESULTS: Among people with Alzheimer''s disease and COVID-19, all-cause 30-day mortality was 29% (47/163) for people taking donepezil compared with 38% (159/419) for those who were not. Among people with Alzheimer''s disease without COVID-19, all-cause 30-day mortality was 5% (189/4189) for people taking donepezil compared with 7% (712/10,241) for those who were not. Adjusting for covariates, the decrease in mortality associated with donepezil did not differ between people with and without COVID-19 (interaction ? = 0.710). CONCLUSION: The known survival benefits of donepezil were retained but not found to be specific to COVID-19 among people with Alzheimer''s disease.




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