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. 2023 Jun 21:15:1206123.
doi: 10.3389/fnagi.2023.1206123. eCollection 2023.

Alzheimer's early detection in post-acute COVID-19 syndrome: a systematic review and expert consensus on preclinical assessments

Clair Vandersteen #  1   2 , Alexandra Plonka #  2   3   4   5 , Valeria Manera  2   4   5 , Kim Sawchuk  6 , Constance Lafontaine  6 , Kevin Galery  7 , Olivier Rouaud  8 , Nouha Bengaied  9 , Cyrille Launay  10 , Olivier Guérin  3   11 , Philippe Robert  2   3   4 , Gilles Allali  8 , Olivier Beauchet  7   10   12 , Auriane Gros  2   3   4
Affiliations

Alzheimer's early detection in post-acute COVID-19 syndrome: a systematic review and expert consensus on preclinical assessments

Clair Vandersteen et al. Front Aging Neurosci. .

Abstract

Introduction: The 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.

Methods: We 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.

Results: Based 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.

Conclusion: Based 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.

Keywords: Alzheimer's disease; biomarkers; early diagnosis; olfactory disorders; post-acute COVID-19 syndrome.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Overview of all RAPAs and their main clinical target assessments. Every detail of these RAPAs and the literature review process we used to summarize them is provided in Supplementary Data Sheet 2.
Figure 2
Figure 2
Overview of the screening process. PRISMA flow diagram of the studies selection process.
See this image and copyright information in PMC

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Grants and funding

This research was funded in whole or in part by the Project ERANET JPcofuND 2-WG and French National Research Agency (ANR) under the Project ANR-22-JPW2-0002-01. With the aim of its open-access publication, the author/rights holder applies an open-access CC BY license to any article/manuscript accepted for publication (AAM) resulting from this submission.

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