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

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

doi:10.3389/fpsyt.2022.947583

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

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

Authors

José Wagner Leonel Tavares-Júnior¹, Danilo Nunes Oliveira¹, Jean Breno Silveira da Silva², Werbety Lucas Queiroz Feitosa¹, Artur Victor Menezes Sousa¹, Letícia Chaves Vieira Cunha¹, Safira de Brito Gaspar³, Carmem Meyve Pereira Gomes³, Laís Lacerda Brasil de Oliveira², Caroline Aquino Moreira-Nunes², Raquel Carvalho Montenegro², Manoel Alves Sobreira-Neto¹, Pedro Braga-Neto^{1

3}

Affiliations

¹ Neurology Section, Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceará (UFC), Fortaleza, CE, Brazil.
² Drug Research and Development Center (NPDM), Pharmacogenetics Laboratory, Federal University of Ceará (UFC), Fortaleza, CE, Brazil.
³ Center of Health Sciences, State University of Ceará, Fortaleza, CE, Brazil.

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.