Huntington's Disease in Hospitalized Patients Infected with SARS-CoV-2 in Brazil: Three-Year Update.

Abstract

Introduction: Huntington's disease (HD) is considered a rare and fatal neurodegenerative disease; despite that, only one study has described the outcomes among individuals with HD and COVID-19. In this context, an epidemiological investigation was conducted in Brazil using data from Open-Data-SUS (https://opendatasus.saude.gov.br/), a Brazilian open dataset encompassing demographic and clinical information of hospitalized patients.

Method: The study comprised 2,180,403 hospitalized patients due to COVID-19 in Brazil from December 29, 2019, to April 6, 2023. From the total original database, patients with HD and three control groups were selected (control 1 [CG-1] - hospitalized patients with COVID-19 and a neurological disorder [except those with HD], control 2 [CG-2] - hospitalized patients with COVID-19 and no comorbidities, and control 3 [CG-3] - hospitalized patients with COVID-19 except for those with HD). The study described the following characteristics of these patients: sex, age, race, place of residence, presence of nosocomial infection, clinical signs, comorbidities, use of antiviral medication for the flu, need for intensive care unit, need for mechanical ventilation support, discharge criteria, and outcome.

Results: A total of 60 patients with HD were enrolled, representing a prevalence of 2.8 per 100,000 inhabitants. Of these, 23 were men, 30 were aged between 25 and 60 years, 38 were White, 58 lived in urban areas, and two had a nosocomial infection. The main clinical signs presented were fever (N = 45), dyspnea (N = 45), peripheral oxygen saturation <95% (N = 45), cough (N = 38), and respiratory discomfort (N = 37). The main comorbidities were cardiopathy (N = 13), asthma (N = 2), and chronic lung disease (N = 2). Four patients received antiviral medication for the flu. During hospitalization, 18 patients required admission to an intensive care unit, 10 used invasive mechanical ventilation, 42 used noninvasive mechanical ventilation, and eight did not use ventilatory support. Regarding outcomes, 36 patients were cured, 23 died due to COVID-19, and 1 died from a cause not associated with COVID-19. In the comparison of markers between patients with HD and the controls, the following significant associations were described: (CG-1) patients with HD were younger and presented fewer clinical signs and comorbidities; (CG-2) patients with HD were commonly female, older, presented fewer clinical signs, and had a higher chance of death (OR = 2.354 [95% CI = 1.395-3.973]); and (CG-3) patients with HD were more commonly female and presented fewer clinical signs and comorbidities.

Conclusions: Patients with HD can be considered an at-risk population due to the poor clinical outcomes compared to patients without comorbidities. Even then, this group of patients presented fewer clinical signs and comorbidities.