Ortiz Genaro Gabriel, Velázquez-Brizuela Irma E, Ortiz-Velázquez Genaro E, Ocampo-Alfaro María J, Salazar-Flores Joel, Delgado-Lara Daniela L C, Torres-Sanchez Erandis D
Department of Philosophical and Methodological Disciplines and Molecular Biology in Medicine Service Hospital Civil, University Health Sciences Center, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico.
Clinical Laboratory, UMF 61, Naucalpan 53000, State of Mexico, Mexico.
Brain Sci. 2022 Oct 18;12(10):1405. doi: 10.3390/brainsci12101405.
The COVID-19 pandemic has proven to be a challenge for healthcare systems, especially in terms of the care of patients with Alzheimer's disease (AD). Age is one of the major risk factors for severe forms of COVID-19, most probably due to the presence of comorbidities and inflammations. It is known that SARS-CoV-2 invades nerve endings and olfactory nerves through the binding of the spike protein to the angiotensin-converting enzyme 2 (ACE2) receptor. This interaction triggers an inflammatory cascade that results in cognitive impairment. In turn, the isoform of apolipoprotein-E4 (APOE-4ε) in AD is a risk factor for increased neuroinflammation through microglia activation, increased oxidative stress, and neurodegeneration. AD and SARS-CoV-2 are associated with increases in levels of inflammatory markers, as well as increases in levels of APOE-4ε, ACE2 and oxidative stress. Thus, there is a synergistic relationship between AD and SARS-CoV-2. In addition, the social isolation and other health measures resulting from the pandemic have led to a higher level of anxiety and depression among AD patients, a situation which may lead to a decline in cognitive function. Therefore, there is a need to develop strategies for keeping the patient calm but active.
事实证明，新冠疫情对医疗系统构成了挑战，尤其是在阿尔茨海默病（AD）患者的护理方面。年龄是新冠重症的主要风险因素之一，很可能是由于存在合并症和炎症。众所周知，严重急性呼吸综合征冠状病毒2（SARS-CoV-2）通过刺突蛋白与血管紧张素转换酶2（ACE2）受体结合，侵入神经末梢和嗅觉神经。这种相互作用引发炎症级联反应，导致认知障碍。反过来，AD中的载脂蛋白E4（APOE-4ε）异构体是通过小胶质细胞激活、氧化应激增加和神经退行性变导致神经炎症增加的风险因素。AD和SARS-CoV-2与炎症标志物水平升高以及APOE-4ε、ACE2和氧化应激水平升高有关。因此，AD和SARS-CoV-2之间存在协同关系。此外，疫情导致的社交隔离和其他健康措施，使AD患者的焦虑和抑郁程度更高，这种情况可能导致认知功能下降。因此，需要制定策略，让患者保持平静但积极活跃。
