Alzheimer Disease Patients Who Survived COVID-19 Have Rapid Disease Progression and a Higher Risk of Death at 5-year Follow-up: A Retrospective Cohort Study
PURPOSE
Alzheimer disease (AD) is the most common neurodegenerative disorder, affecting millions worldwide. COVID-19 has increased the risk of acute complications and death for patients with AD, but the long-term effects on survivors have been little studied. Thus, given the potential role of SARS-CoV-2 in accelerating cognitive decline, this study aimed to assess the effect of COVID-19 on functional deterioration, AD progression, and mortality in these patients.
METHODS
This retrospective cohort study examined medical records of patients with mild to moderate AD treated at a public dementia clinic in southern Brazil between March 2020 and March 2025. Sociodemographic and clinical data were extracted, including COVID-19 status confirmed by molecular testing. AD progression was assessed using the Mini-Mental State Examination (MMSE) and the Katz Index. Multivariate statistical analyses were conducted to identify associations between COVID-19 infection and disease progression. Survival was described by Kaplan-Meier test and analyzed by Cox regression.
RESULTS
A total of 105 individuals with [AD] were included, of whom 28 (26.7%) were COVID-19 survivors during the follow-up period. COVID-19 patients showed rapid AD progression compared with the control group (OR 4.76; 95% CI: 1.04-21.7; P = 0.044). Likewise, SARS-CoV-2 infection decreased patients functionality, as indicated by the Katz index (P=0.001). Functional impairment was observed in both mild and hospitalized cases of COVID-19. Hospitalized patients during COVID-19 demonstrated lower survival rates at the 5-year follow-up.
CONCLUSION
These findings suggest that SARS-CoV-2 infection may accelerate AD progression and reduce survival, particularly in cases requiring hospitalization. Future multicenter studies with large sample sizes are needed to confirm these findings.
PLAIN LANGUAGE SUMMARY
This study explored how COVID-19 affects people with mild to moderate Alzheimer disease (AD) in Brazil. Researchers reviewed medical records from 2020 to 2025, focusing on cognitive decline and survival rates. Among 105 patients, 28 were COVID-19 survivors during the follow-up period. COVID-19 patients showed rapid AD progression compared with the control group (OR 4.76; 95% CI: 1.04-21.7; P = 0.044) and decreased functionality, as indicated by the Katz index (P=0.001). Functional impairment was observed in both mild and hospitalized cases of COVID-19. Hospitalized patients during COVID-19 demonstrated lower survival rates at the 5-year follow-up. These results suggest COVID-19 may worsen AD and decrease survival, highlighting the need for larger studies to confirm these findings.
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Ursi, Giulia Zaparoli; da Silva, Mateus Ribeiro; Nakakogue, Lindsey Mitie; Fernandes, Karen Barros Parron; Bignardi, Paulo Roberto
PURPOSE
Alzheimer disease (AD) is the most common neurodegenerative disorder, affecting millions worldwide. COVID-19 has increased the risk of acute complications and death for patients with AD, but the long-term effects on survivors have been little studied. Thus, given the potential role of SARS-CoV-2 in accelerating cognitive decline, this study aimed to assess the effect of COVID-19 on functional deterioration, AD progression, and mortality in these patients.
METHODS
This retrospective cohort study examined medical records of patients with mild to moderate AD treated at a public dementia clinic in southern Brazil between March 2020 and March 2025. Sociodemographic and clinical data were extracted, including COVID-19 status confirmed by molecular testing. AD progression was assessed using the Mini-Mental State Examination (MMSE) and the Katz Index. Multivariate statistical analyses were conducted to identify associations between COVID-19 infection and disease progression. Survival was described by Kaplan-Meier test and analyzed by Cox regression.
RESULTS
A total of 105 individuals with [AD] were included, of whom 28 (26.7%) were COVID-19 survivors during the follow-up period. COVID-19 patients showed rapid AD progression compared with the control group (OR 4.76; 95% CI: 1.04-21.7; P = 0.044). Likewise, SARS-CoV-2 infection decreased patients functionality, as indicated by the Katz index (P=0.001). Functional impairment was observed in both mild and hospitalized cases of COVID-19. Hospitalized patients during COVID-19 demonstrated lower survival rates at the 5-year follow-up.
CONCLUSION
These findings suggest that SARS-CoV-2 infection may accelerate AD progression and reduce survival, particularly in cases requiring hospitalization. Future multicenter studies with large sample sizes are needed to confirm these findings.
PLAIN LANGUAGE SUMMARY
This study explored how COVID-19 affects people with mild to moderate Alzheimer disease (AD) in Brazil. Researchers reviewed medical records from 2020 to 2025, focusing on cognitive decline and survival rates. Among 105 patients, 28 were COVID-19 survivors during the follow-up period. COVID-19 patients showed rapid AD progression compared with the control group (OR 4.76; 95% CI: 1.04-21.7; P = 0.044) and decreased functionality, as indicated by the Katz index (P=0.001). Functional impairment was observed in both mild and hospitalized cases of COVID-19. Hospitalized patients during COVID-19 demonstrated lower survival rates at the 5-year follow-up. These results suggest COVID-19 may worsen AD and decrease survival, highlighting the need for larger studies to confirm these findings.
Web | PDF | Alzheimer Disease & Associated Disorders | Paywall