Title:APOE4: A Culprit for the Vulnerability of COVID-19 in Alzheimer's
Patients
Volume: 20
Issue: 1
Author(s): Ahsas Goyal, Prashant Singh Kushwah, Neetu Agrawal*Shilpi Pathak
Affiliation:
- Institute of Pharmaceutical Research, GLA University, Mathura, U.P., India
Keywords:
APOE4, apolipoprotein, alzheimer, COVID-19, amyloid-β, SARS-CoV-2.
Abstract: 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.