Background: Although COVID-19 has been linked to worse acute outcomes in patients with some neurodegenerative disorders, its long-term impact on dementia remains unclear. Objective: To investigate the outcomes of COVID-19 survivors with dementia. Methods: This retrospective study evaluated 9806 patients with dementia in the Montefiore Health System (January 2016 to July 2023). Comparisons were made between dementia patients with and without a positive SARS-CoV-2 polymerase-chain-reaction test who had a follow-up at least two weeks post-infection. Outcomes included all-cause mortality, major adverse cardiovascular events (MACE), new-onset dysphagia, dyspnea, fatigue, new-onset sleep disturbances, altered mental status, first-time fall, headache, new-onset depression, and new-onset anxiety. Adjusted hazard ratios (aHR) were computed adjusting for age, sex, race, ethnicity, and pre-existing comorbidities. Results: Dementia patients with COVID-19 were younger, more likely to be male, and had a higher prevalence of major pre-existing comorbidities compared to those without COVID-19. Patients who survived acute COVID-19 were more likely to die than non-COVID controls after adjusting for covariates (aHR = 1.65 [1.43, 1.91]). COVID-19 was significantly associated with higher risk of MACE (aHR = 1.58 [1.41, 1.78]), new-onset dysphagia (aHR = 1.64 [1.42, 1.91]), dyspnea (aHR = 1.27 [1.12, 1.44]), fatigue (aHR = 1.42 [1.22, 1.65]), new-onset sleep disturbances (aHR = 1.36 [1.15, 1.60]), altered mental status (aHR = 1.36 [1.16, 1.59]), and first-time fall (aHR = 1.34 [1.09, 1.65]). Conclusions: COVID-19 increases the risk of mortality and other adverse health outcomes in dementia patients. These findings highlight the need for closer follow-up and management strategies for dementia patients post-COVID-19.

Background/Objectives: Although COVID-19 has been linked to worse outcomes in patients with neurological disorders, its impact on those with essential tremor (ET) remains unclear. To investigate clinical outcomes of ET patients with and without COVID-19 three and a half years post-pandemic. Methods: 1074 ET patients were evaluated in this retrospective study in the Montefiore Health System from January 2016 to July 2023. Comparisons between ET patients with and without a positive SARS-CoV-2 polymerase chain reaction test were made. Outcomes included post-index date major adverse cardiovascular events (MACEs), new-onset sleep disturbances, fatigue, dyspnea, first-time fall, new-onset anxiety, new-onset depression, headache, new-onset imbalance, new-onset mild cognitive impairment, and all-cause mortality, adjusted hazard ratios (aHR) adjusting for covariates were calculated. Results: ET patients with COVID-19 had higher prevalence of pre-existing type-2 diabetes, depression, and anxiety compared to ET patients without COVID-19. COVID-19 was significantly associated with higher risk of MACEs, (aHR = 2.39 [1.49, 3.82]), new-onset sleep disturbance, (aHR = 2.12 [1.44, 3.13]), fatigue, (aHR = 1.83 [1.27, 2.65]), dyspnea, (aHR = 1.98 [1.40, 2.80]), first-time fall, (aHR = 4.76 [2.24, 10.14]), new-onset anxiety, (aHR = 3.66 [2.02, 6.64]), and new-onset depression, (aHR = 2.38 [1.20, 4.70]). COVID-19 was not associated with all-cause mortality. Conclusions: In patients with ET, COVID-19 significantly increases the risk of several long-term adverse health outcomes, but not mortality.

Purpose: To determine the incidence of newly diagnosed liver disorders (LD) up to 3.5-year post-acute COVID-19, and risk factors associated with new LD. Methods: We analyzed 54,699 COVID-19 patients and 1,409,547 non-COVID-19 controls from March-11-2020 to Jan-03-2023. New liver disorders included abnormal liver function tests, advanced liver failure, alcohol and non-alcohol related liver disorders, and cirrhosis. Comparisons were made with ambulatory non-COVID-19 patients and patients hospitalized for other lower respiratory tract infections (LRTI). Demographics, comorbidities, laboratory data, incomes, insurance status, and unmet social needs were tabulated. The primary outcome was new LD at least two weeks following COVID-19 positive test. Results: Incidence of new LD was not significantly different between COVID-19 and non-COVID-19 cohorts (incidence:1.99% vs 1.90% p>0.05, OR = 1.04[95%CI: 0.92,1.17], p = 0.53). COVID-19 patients with new LD were older, more likely to be Hispanic and had higher prevalence of diabetes, hypertension, chronic kidney disease, and obesity compared to patients without new LD. Hospitalized COVID-19 patients had no elevated risk of LD compared to hospitalized LRTI patients (2.90% vs 2.07%, p>0.05, OR = 1.29[0.98,1.69], p = 0.06). Among COVID-19 patients, those who developed LD had fewer patients with higher incomes (14.18% vs 18.35%, p<0.05) and more with lower incomes (21.72% vs 17.23%, p3 unmet social needs (6.49% vs 2.98%, p<0.001) and fewer with no unmet social needs (76.19% vs 80.42%, p<0.001). Conclusions: Older age, Hispanic ethnicity, and obesity, but not COVID-19 status, posed increased risk for developing new LD. Lower socioeconomic status was associated with higher incidence of new LD.

Background/Objectives: Although kidney transplant recipients (KTRs) who are immune-compromised have been shown to be at high risk of adverse acute COVID-19 outcomes (i.e., mortality and critical illness), the long-term outcomes of KTRs with a history of SARS-CoV-2 infection are unknown. We aimed to compare long-term outcomes of KTRs with and without exposure to SARS-CoV-2. Methods: This study retrospectively evaluated 1815 KTRs in the Montefiore Health System from 4 January 2001 to 31 January 2024. The final cohorts consisted of KTRs who survived COVID-19 (n = 510) and matched KTRs without COVID-19 (n = 510, controls). Outcomes were defined as all-cause mortality and changes in estimated glomerular filtration rate (eGFR) and urine protein to creatinine ratio (UPCR) from 30 days up to four years post index date. Kaplan–Meier survival analysis and Cox proportional modeling were performed for mortality. Generalized estimating equations were used to analyze changes in eGFR and UPCR across time. Results: There was no significant group difference in long-term all-cause mortality (adjusted hazard ratio = 0.66, [0.43, 1.01] p = 0.057). eGFR in controls and COVID-19 patients before infection similarly decreased −0.98 units/year [−1.50, −0.46]. By contrast, eGFR declined at a significantly greater rate (−1.80 units/year [−2.45, −1.15]) in KTRs after COVID-19 compared to KTRs without COVID-19. This association was only seen among male and not female KTRs. COVID-19 status was not significantly associated with rate of change in UPCR or acute kidney rejection rate. Conclusions: SARS-CoV-2 infection was associated with an accelerated decline in eGFR up to four years post infection, suggesting potential long-term implications for graft health. These findings underscore the importance of vigilant monitoring and management of kidney function post SARS-CoV-2 infection in this vulnerable population.

Background: The purpose of this study was to test the hypothesis that COVID‐19 status increases the incidence of new hypertension (HTN) and chronic kidney disease (CKD) in patients with Type 2 diabetes (T2D). Methods: This retrospective study consisted of 46,448 patients with T2D from the Montefiore Health System in the Bronx (3/01/2020–7/01/2023), of which 13,801 had a positive COVID‐19 test on record. Contemporary controls included those hospitalized for other lower respiratory tract infections (LRTIs) ( n = 1638) and nonhospitalized patients without COVID‐19 or LRTI ( n = 31009). Outcomes were assessed at follow‐up (2 months to 3 years) relative to baseline. Adjusted hazards ratios (aHRs) with 95% confidence interval (CI) were computed. Results: The cumulative incidences of HTN (22.32% vs. 9.13%, p < 0.001) and CKD (6.20% vs. 2.03%, p 0.05). Nonhospitalized COVID‐19 patients had higher risk of developing HTN compared to non‐COVID patients during all follow‐up (aHR 1.99, 95% CI [1.54, 2.57], p < 0.001), but hospitalized COVID‐19 patients had similar risk of developing HTN relative to patients hospitalized for LRTI (aHR 1.26 [0.70, 2.27], p = 0.441). Nonhospitalized COVID‐19 patients had higher risk of developing CKD compared to non‐COVID patients during all follow‐up (aHR 2.09 [1.69, 2.76], p < 0.001), but hospitalized COVID‐19 patients had similar risk of developing CKD relative to patients hospitalized for LRTI (aHR 0.96 [0.79, 1.36], p = 0.131). Conclusions: T2D patients with COVID‐19 were at higher risk of developing new disorders compared with COVID‐19‐negative controls and were at similar risk compared with those hospitalized for other LRTIs.

Background: Coronavirus disease 2019 (COVID-19) could increase susceptibility to future pulmonary infections. Given the sheer number of individuals infected by severe acute respiratory syndrome coronavirus 2, increased prevalence of future pulmonary infections could be a public health concern. Methods: We conducted a retrospective study to determine whether COVID-19 is associated with increased incidence of future pneumonia. In an urban population in Montefiore Health System in the Bronx between 1 March 2020 and 31 January 2024, there were 64 376 patients with a history of COVID-19, 1.2 million patients without (controls), and 8468 patients with influenza without COVID-19. Controls were propensity matched. Multivariate Cox adjusted hazard ratios (aHRs) with 95% confidence interval (CIs) accounting for confounders were calculated. Outcomes were also analyzed with respect to comorbid conditions, median incomes, insurance status, and unmet social needs. Results: Hospitalized (aHR, 3.69 [95% CI, 3.29–4.15]) and nonhospitalized (aHR, 1.40 [1.27–1.55]) patients with COVID-19 had higher risks of future pneumonia than controls. Hospitalized patients with COVID-19 experienced more recurrent pneumonia episodes than nonhospitalized patients with COVID-19 (2.3 vs 1.93 cases per patient, respectively; P < .05), who also had a higher rate of recurrence than the control group (1.71 cases per patient). Individuals on Medicaid (aHR, 1.40 [95% CI, 1.26­–1.55]) or Medicare (2.39 [2.12­–2.69]) (relative to private insurance) and those with unmet social needs (aHR, 1.34 [1.12–1.60]) were at even higher risks of outcomes. Hospitalized patients with COVID-19 had a higher adjusted risk of outcomes than patients with influenza (aHR, 2.89 [95% CI, 2.26–3.69]). Risks of outcomes varied by COVID-19 variants/waves. Conclusions: COVID-19 is associated with a higher risk of new-onset pneumonia. Patients with lower socioeconomic status or unmet needs were at higher risk.