Comparing the Long-Term Impact of COVID-19 on the Progression of Alzheimer's Disease in an Elderly Population with Real-Time Monitoring as a Prognosis
Archives of Advances in Biosciences,
Vol. 16 No. 1 (2025),
2 March 2025
,
Page 1-10
https://doi.org/10.22037/aab.v16i1.50780
Abstract
Background and Aim: Despite growing awareness of “long COVID” and its neurological sequelae, the long-term influence of SARS-CoV-2 infection on Alzheimer’s progression remains poorly understood. This study aimed to compare the long-term impact of COVID-19 on the progression of AD in elderly individuals, integrating real-time digital monitoring and biomarker analytics to establish predictive prognostic models.
Methods: A longitudinal cohort of 348 participants (age≥65 years) diagnosed with early-to-moderate AD was followed over four years (2021–2025). Participants were divided into COVID-19 positive (n=174) and COVID-19 negative (n=174) groups, matched for age, sex, and comorbidities. Serum inflammatory markers (IL-6, TNF-α, CRP), neurofilament light chain (NfL), and amyloid-β/tau ratios were analyzed biannually. Machine learning algorithms were applied to identify prognostic patterns linking infection-related biomarkers with cognitive and functional decline.
Results: COVID-19-positive AD patients showed a 29% faster rate of cognitive deterioration, indicating a strong association rather than a confirmed causal relationship—between prior SARS-CoV-2 infection and accelerated AD progression (p<0.01) and a 33% increase in NfL levels compared to controls. Real-time monitoring detected significant fluctuations in sleep quality, gait stability, and heart rate variability within six months post-infection, which preceded measurable cognitive decline. Predictive modeling achieved an accuracy of 87% in forecasting accelerated progression trajectories using combined digital and biochemical markers.
Conclusion: The incorporation of wearable and biochemical data into prognostic modeling marks a paradigm shift toward personalized, predictive neurology, enabling clinicians to anticipate and mitigate the long-term neurological consequences of COVID-19 in the aging population.
- Alzheimer Disease
- Lymphopenia
- Single Cell Gel Electrophoresis
- DNA Damage
- Post Acute COVID 19 Syndrome
How to Cite
References
1. Brown EE, Kumar S, Rajji TK, Pollock BG, Mulsant BH. Anticipating and mitigating the impact of the COVID-19 pandemic on Alzheimer's disease and related dementias. The American Journal of Geriatric Psychiatry. 2020 Jul 1;28(7):712-21.[PMID]
2. Yu DT, Li RX, Sun JR, Rong XW, Guo XG, Zhu GD. Global mortality, prevalence and disability-adjusted life years of Alzheimer’s disease and other dementias in adults aged 60 years or older, and the impact of the COVID-19 pandemic: a comprehensive analysis for the global burden of disease 2021. BMC psychiatry. 2025 May 19;25(1):503.[PMID]
3. Trew BT, Edwards DP, Lees AC, Klinges DH, Early R, Svátek M, Plichta R, Matula R, Okello J, Niessner A, Barthel M. Novel temperatures are already widespread beneath the world’s tropical forest canopies. Nature Climate Change. 2024 Jul;14(7):753-9. [LINK]
4. Nath D, Nath R, Chen W. Faster dieback of rainforests altering tropical carbon sinks under climate change. npj Climate and Atmospheric Science. 2024 Oct 6;7(1):235. [LINK]
5. Schaeffer R, Schipper EL, Ospina D, Mirazo P, Alencar A, Anvari M, Artaxo P, Biresselioglu ME, Blome T, Boeckmann M, Brink E. Ten new insights in climate science 2024. One Earth. 2025 May 7. [PMID]
6. Marcotullio PJ, Keßler C, Quintero Gonzalez R, Schmeltz M. Urban growth and heat in tropical climates. Frontiers in Ecology and Evolution. 2021 Aug 13;9:616626. [LINK]
7. Duff EP, Zetterberg H, Heslegrave A, Dehghan A, Elliott P, Allen N, Runz H, Laban R, Veleva E, Whelan CD, Sun BB. Plasma proteomic evidence for increased β-amyloid pathology after SARS-CoV-2 infection. Nature Medicine. 2025 Mar;31(3):797-806. [PMID]
8. Gutman EG, Salvio AL, Fernandes RA, Duarte LA, Raposo-Vedovi JV, Alcaraz HF, Teixeira MA, Passos GF, de Medeiros KQ, Hammerle MB, Pires KL. Long COVID: plasma levels of neurofilament light chain in mild COVID-19 patients with neurocognitive symptoms. Molecular Psychiatry. 2024 Oct;29(10):3106-16. [PMID]
9. Eratne D, Kang MJ, Lewis C, Dang C, Malpas CB, Keem M, Grewal J, Marinov V, Coe A, Kaylor‐Hughes C, Borchard T. Plasma and CSF neurofilament light chain distinguish neurodegenerative from primary psychiatric conditions in a clinical setting. Alzheimer's & Dementia. 2024 Nov;20(11):7989-8001. [PMID]
10. Hofmann A, Häsler LM, Lambert M, Kaeser SA, Gräber-Sultan S, Obermüller U, Kuder-Buletta E, La Fougere C, Laske C, Vöglein J, Levin J. Comparative neurofilament light chain trajectories in CSF and plasma in autosomal dominant Alzheimer’s disease. Nature communications. 2024 Nov 18;15(1):9982.[PMID]
11. Körtvelyessy P, Diekämper E, Ruprecht K, Endres M, Stubbemann P, Kurth F, Graw JA, Menk M, Kuhle J, Wohlrab F. Serum neurofilament light chain in COVID-19 and the influence of renal function. European Journal of Medical Research. 2023 Sep 28;28(1):389. [PMID]
12. Chudzik A, Śledzianowski A, Przybyszewski AW. Machine learning and digital biomarkers can detect early stages of neurodegenerative diseases. Sensors. 2024 Feb 29;24(5):1572. [PMID]
13. Ouyang X, Shuai X, Li Y, Pan L, Zhang X, Fu H, Cheng S, Wang X, Cao S, Xin J, Mok H. ADMarker: A Multi-Modal Federated Learning System for Monitoring Digital Biomarkers of Alzheimer's Disease. InProceedings of the 30th Annual International Conference on Mobile Computing and Networking 2024 May 29 (pp. 404-419). [PMID]
14. Yamada Y, Shinakwa K, Kobayashi M, Nemoto M, Ota M, Nemoto K, Arai T. Smartwatch-derived Acoustic Markers for Deficits in Cognitively Relevant Everyday Functioning. In2023 IEEE International Conference on Digital Health (ICDH) 2023 Jul 2 (pp. 39-49). IEEE.[LINK]
15. Lott SA, Streel E, Bachman SL, Bode K, Dyer J, Fitzer-Attas C, Goldsack JC, Hake A, Jannati A, Fuertes RS, Fromy P. Digital health technologies for Alzheimer's disease and related dementias: initial results from a landscape analysis and community collaborative effort. The Journal of Prevention of Alzheimer's Disease. 2024 Oct 1;11(5):1480-9. [PMID]
16. Moscoso A, Grothe MJ, Ashton NJ, Karikari TK, Rodríguez JL, Snellman A, Suárez-Calvet M, Blennow K, Zetterberg H, Schöll M, Weiner MW. Longitudinal associations of blood phosphorylated Tau181 and neurofilament light chain with neurodegeneration in Alzheimer disease. JAMA neurology. 2021 Apr 1;78(4):396-406. [PMID]
17. Zhou Y, Xu J, Hou Y, Leverenz JB, Kallianpur A, Mehra R, Liu Y, Yu H, Pieper AA, Jehi L, Cheng F. Network medicine links SARS-CoV-2/COVID-19 infection to brain microvascular injury and neuroinflammation in dementia-like cognitive impairment. Alzheimer's research & therapy. 2021 Jun 9;13(1):110.[PMID]
18. Zhang Q, Yang G, Luo Y, Jiang L, Chi H, Tian G. Neuroinflammation in Alzheimer’s disease: insights from peripheral immune cells. Immunity & Ageing. 2024 Jun 14;21(1):38.[PMID]
19. Qi X, Yuan S, Ding J, Sun W, Shi Y, Xing Y, Liu Z, Yao Y, Fu S, Sun B, Qi X. Emerging signs of Alzheimer‐like tau hyperphosphorylation and neuroinflammation in the brain post recovery from COVID‐19. Aging Cell. 2024 Nov;23(11):e14352. [PMID]
20. Achar A, Ghosh C. COVID-19-associated neurological disorders: the potential route of CNS invasion and blood-brain barrier relevance. Cells. 2020 Oct 27;9(11):2360.[PMID]
21. Shabani Z, Liu J, Su H. Vascular dysfunctions contribute to the long-term cognitive deficits following COVID-19. Biology. 2023 Aug 9;12(8):1106.[PMID]
22. Goerss D, Amaefule CO, Kowe A, Köhler S, Teipel SJ. Monitoring physical parameters from wearable sensors for detection of cognitive decline in routine care. Alzheimer's & Dementia. 2021 Dec;17:e049767. [LINK]
23. Concha R, Ohayon E, Lam A. Neuroinflammation in COVID‐19 and ADRD: Similarities, differences, and interactions. Alzheimer's & Dementia. 2021 Dec;17:e056282.[LINK]
24. Braga J, Lepra M, Kish SJ, Rusjan PM, Nasser Z, Verhoeff N, Vasdev N, Bagby M, Boileau I, Husain MI, Kolla N. Neuroinflammation after COVID-19 with persistent depressive and cognitive symptoms. JAMA psychiatry. 2023 Aug 1;80(8):787-95. [PMID]
25. McQuaid C, Montagne A. SARS-CoV-2 and vascular dysfunction: a growing role for pericytes. Cardiovascular Research. 2023 Nov;119(16):2591-3. [PMID]
26. Zhang H, Zhou Z. COVID‐19 and the risk of Alzheimer's disease, amyotrophic lateral sclerosis, and multiple sclerosis. Annals of Clinical and Translational Neurology. 2022 Dec;9(12):1953-61.[PMID]
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