Detecting Alzheimer’s in COVID-19 patients: A closer look at preclinical assessments

Published on June 21, 2023

Imagine if you could detect the early signs of Alzheimer’s disease by simply sniffing a familiar scent. Well, according to a systematic review and expert consensus, olfaction is the most long-lasting impairment found in COVID-19 patients with post-acute syndrome (PACS). But here’s the catch – experts recommend that olfactory screening for Alzheimer’s should only be done once the patients have fully recovered. It’s like waiting for a cake to fully bake before checking if it’s done! This consensus statement highlights the importance of conducting more long-term studies on PACS patients after they have achieved complete recovery. Who knows what other clues we may uncover in the process? So, if you’re curious about the link between COVID-19 and Alzheimer’s, dive into the fascinating research behind remote digital assessments for preclinical AD and explore the world of PACS!

IntroductionThe risk of developing Alzheimer’s disease (AD) in older adults increasingly is being discussed in the literature on Post-Acute COVID-19 Syndrome (PACS). Remote digital Assessments for Preclinical AD (RAPAs) are becoming more important in screening for early AD, and should always be available for PACS patients, especially for patients at risk of AD. This systematic review examines the potential for using RAPA to identify impairments in PACS patients, scrutinizes the supporting evidence, and describes the recommendations of experts regarding their use.MethodsWe conducted a thorough search using the PubMed and Embase databases. Systematic reviews (with or without meta-analysis), narrative reviews, and observational studies that assessed patients with PACS on specific RAPAs were included. The RAPAs that were identified looked for impairments in olfactory, eye-tracking, graphical, speech and language, central auditory, or spatial navigation abilities. The recommendations’ final grades were determined by evaluating the strength of the evidence and by having a consensus discussion about the results of the Delphi rounds among an international Delphi consensus panel called IMPACT, sponsored by the French National Research Agency. The consensus panel included 11 international experts from France, Switzerland, and Canada.ResultsBased on the available evidence, olfaction is the most long-lasting impairment found in PACS patients. However, while olfaction is the most prevalent impairment, expert consensus statements recommend that AD olfactory screening should not be used on patients with a history of PACS at this point in time. Experts recommend that olfactory screenings can only be recommended once those under study have reported full recovery. This is particularly important for the deployment of the olfactory identification subdimension. The expert assessment that more long-term studies are needed after a period of full recovery, suggests that this consensus statement requires an update in a few years.ConclusionBased on available evidence, olfaction could be long-lasting in PACS patients. However, according to expert consensus statements, AD olfactory screening is not recommended for patients with a history of PACS until complete recovery has been confirmed in the literature, particularly for the identification sub-dimension. This consensus statement may require an update in a few years.

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