Impact of SARS-CoV-2 infection on the progression of Alzheimer's disease: A prospective cohort study
Jiating Qiu, Yishu Zhang, Yajun Shang, Qunzhu Shang, Lu Li, Yili Chen, Shujuan Dai, Mingda Ai, Xiaoting Xi, Wei Huang, Junyan Zhang, Xiaolei LiuBackground
SARS-CoV-2 infection is associated with neurological sequelae and may accelerate Alzheimer's disease (AD) progression through neuroinflammation and protein aggregation. However, longitudinal evidence regarding the cognitive impact of COVID-19 in patients with AD remains scarce, and this interaction requires further clarification.
Objective
To explore whether COVID-19 accelerates cognitive decline in patients with AD.
Methods
A total of 120 participants were enrolled, including 63 in the COVID-19 group and 57 in the non-COVID-19 group. The primary outcomes were disease decline and disease deterioration over three months, assessed using CDR-SB. Disease deterioration indicated clinically meaningful worsening, whereas disease decline captured subtler progression. Multivariable logistic regression adjusted for demographic, clinical, lifestyle, genetic, and disease severity factors. Overlap-Weighted Propensity Score Matching was additionally performed to reduce confounding during the 3-month follow-up.
Results
COVID-19 significantly increased the risk of disease decline (OR = 10.39, 95% CI:3.87 to 27.87, p < 0.001) and disease deterioration (OR = 10.37, 95% CI: 2.71 to 39.65, p = 0.001).
Conclusions
SARS-CoV-2 infection was associated with greater short-term cognitive worsening over a three-month period in patients with AD, underscoring its potential public health relevance and the need for early surveillance to guide timely clinical management.