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. 2022 Aug 10:13:947583.
doi: 10.3389/fpsyt.2022.947583. eCollection 2022.

Long-covid cognitive impairment: Cognitive assessment and apolipoprotein E (APOE) genotyping correlation in a Brazilian cohort

José Wagner Leonel Tavares-Júnior  1 , Danilo Nunes Oliveira  1 , Jean Breno Silveira da Silva  2 , Werbety Lucas Queiroz Feitosa  1 , Artur Victor Menezes Sousa  1 , Letícia Chaves Vieira Cunha  1 , Safira de Brito Gaspar  3 , Carmem Meyve Pereira Gomes  3 , Laís Lacerda Brasil de Oliveira  2 , Caroline Aquino Moreira-Nunes  2 , Raquel Carvalho Montenegro  2 , Manoel Alves Sobreira-Neto  1 , Pedro Braga-Neto  1   3
Affiliations

Long-covid cognitive impairment: Cognitive assessment and apolipoprotein E (APOE) genotyping correlation in a Brazilian cohort

José Wagner Leonel Tavares-Júnior et al. Front Psychiatry. .

Abstract

Introduction: Few studies have objectively evaluated cognitive deficits after the acute phase of COVID-19 disease. Moreover, the role of apolipoprotein E (APOE) genotypes in cognitive decline in patients with COVID-19 has not been evaluated yet.

Methods: This cross-sectional study was conducted in confirmed cases of COVID-19 patients with neurological symptoms that persisted for more than 3 months from the onset. We determined APOE genotypes.

Results: The final sample consisted of 141 patients. The most frequent APOE genotype was E3/E3 (N = 95; 67.3%). In total, 93 patients (65.9%) had memory impairment symptoms as the main complaint, objectively confirmed through screening tests in 25 patients (17.7%). Patients with cognitive impairment had a lower frequency of anosmia than the normal and subjective cognitive decline (SCD) groups (p = 0.005). In addition, depression was recurrent in the cognitive impairment group and the SCD group (p = 0.046). Cognitive impairment was significantly more frequent in hospitalized patients and those with a lower education level. Cognitive status was not associated with APOE genotypes.

Discussion: Hospitalized patients had more severe infection with a greater possibility of systemic complications, greater inflammatory response, and prolonged hospitalization, which could impact cognitive performance. Cognitive impairment in patients with COVID-19 does not necessarily involve specific APOE polymorphisms. However, psychiatric disorders may also be responsible for cognitive complaints. Cognitive complaints are frequent in patients with COVID-19, even after the acute phase of the disease and in mild cases. Hospitalized participants and depressed patients may have a higher risk of cognitive impairment. APOE genotypes or haplotypes may not significantly play a role in COVID-19 cognitive impairment.

Keywords: COVID-19; SARS-CoV-2 infection; cognitive impairment; dementia; risk factor.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram of participants. *E.g., headache, anosmia, cognitive complaints and others.
Figure 2
Figure 2
Comparison of age according cognitive status. ANOVA test was applied with Tukey post-test. ** p < 0.05 between CI vs. SCD and Normal in multiple using Tukey's test.
Figure 3
Figure 3
Box-plot representing total ACE-R and subitens scores comparison in relation of patients cognitive status. (A) Total ACE-R; (B) Attention and orientation; (C) Memory; (D) Fluency; (E) Language; (F) Visuospatial. *Kruskal-Wallis test was applied with Dunn post-test. (A) p < 0.05 between CI vs. SCD and Normal. CI, coginitve impaired; SCD, subjective cognitive decline.
Figure 4
Figure 4
Box-plot representing MEEM, Beck and Pfeffer comparison in relation of patients cognitive status. (A) MMSE; (B) Beck; (C) Pfeffer. The asterisk symbol used to indicate the type of statistical test used to calculate p.
See this image and copyright information in PMC

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