Post-COVID-19 Cognitive Decline and Apoe Polymorphism: Towards a Possible Link?

Area of Science:

• Neurology
• Genetics
• Infectious Diseases

Background:

• COVID-19 can cause persistent neurological symptoms, including cognitive deficits.
• The apolipoprotein E (APOE) ε4 allele is a known risk factor for cognitive impairment.

Purpose of the Study:

• To investigate the association between COVID-19, cognitive impairment, and APOE gene polymorphism in outpatients.
• To determine if APOE ε4 influences cognitive decline following SARS-CoV-2 infection.

Main Methods:

• Cross-sectional study of 219 COVID-19 outpatients with persistent neurological symptoms (>3 months).
• APOE genotyping performed on 186 participants.
• Cognitive function assessed using Addenbrooke Cognitive Examination-Revised and Mini-Mental State Examination.

Main Results:

• 16.4% of patients showed objectively verified cognitive decline.
• The APOE ε4 allele was more prevalent in the cognitive decline group (30.8% vs. 16.4%).
• APOE ε4, anxiety symptoms, and sleep disorders were significantly associated with cognitive decline after multivariate analysis.

Conclusions:

• The APOE ε4 allele is associated with cognitive impairment in COVID-19 survivors.
• Anxiety symptoms and sleep disorders are more frequent in patients with post-COVID cognitive decline.
• Cognitive changes can occur even in mild COVID-19 cases, highlighting the need for assessment.