APOE4: A Culprit for the Vulnerability of COVID-19 in Alzheimer's Patients

• Published in: Current neurovascular research Vol. 20; no. 1; p. 162
• Main Authors: Goyal, Ahsas, Kushwah, Prashant Singh, Agrawal, Neetu, Pathak, Shilpi
• Format: Journal Article
• Language: English
• Published: United Arab Emirates 01.01.2023
• Subjects: Alzheimer Disease - metabolism; Amyloid beta-Peptides - metabolism; Apolipoprotein E4 - genetics; Apolipoprotein E4 - metabolism; Brain - metabolism; COVID-19 - metabolism; Humans; Pandemics; SARS-CoV-2; COVID-19; alzheimer; amyloid-β; SARS-CoV-2; apolipoprotein; APOE4
• ISSN: 1875-5739
• DOI: 10.2174/1567202620666230202140612

Apolipoprotein E4 (APOE4) is one of the primary genetic risk factors for late-onset of Alzheimer's disease (AD). While its primary function is to transport cholesterol, it also regulates metabolism, aggregation, and deposition of amyloid-β (Aβ) in the brain. The disruption in the generation and removal of Aβ in the brain is the primary cause of memory and cognitive loss and thus plays a significant role in the development of AD. In several prior genetic investigations, the APOE4 allele has been linked to higher susceptibility to severe acute respiratory syndrome (SARSCoV- 2) infection and COVID-19 mortality. However, information on the involvement of APOE4 in the underlying pathology and clinical symptoms is limited. Due to the high infection and mortality rate of COVID-19 in AD individuals, challenges have been identified in the management of AD patients during the COVID-19 pandemic. In order to provide evidence-based, more effective healthcare, it is critical to identify underlying concerns and, preferably, biomarkers. The risk variant APOE4 imparts enhanced infectivity by the underlying coronavirus SARS-CoV-2 at a cellular level, genetic level, and route level. Here we review existing advances in clinical and basic research on the AD-related gene APOE, as well as the role of APOE in AD pathogenesis, using neurobiological evidence. Moreover, the role of APOE in severe COVID-19 in Alzheimer's patients has also been reviewed.