Blood neurofilament light concentration at admittance: a potential prognostic marker in COVID-19

• DOI: 10.1007/s00415-021-10517-6
• Publication Date: 2021-03-20T15:02:47Z
• Authors: Anne Hege Aamodt; Einar August Høge...; Trine Haug Popperud; Jan Cato Holter; Anne Ma Dyrhol-Riise; Kristian Tonby; Birgitte Stiksrud; Else Quist-Paulsen; Tone Berge; Andreas Barratt-Due; Pål Aukrust; Lars Heggelund; Kaj Blennow; Henrik Zetterberg; Hanne Flinstad Harbo
• Keywords: 0301 basic medicine; Neurofilament light; Original Communication; SARS-CoV-2; Intermediate Filaments; 610; COVID-19; Glial fibrillary acidic protein; Prognosis; 3. Good health; Glial fibrillary acidic proteins; 03 medical and health sciences; Neurofilament Proteins; Neurofilament lights; Glial Fibrillary Acidic Protein; Humans; Mortality; Biomarkers

Abstract Objective To test the hypotheses that blood biomarkers for nervous system injury, serum concentrations of neurofilament light chain protein (NfL) and glial fibrillary acidic protein (GFAp) can serve as biomarkers for disease severity in COVID-19 patients.

Methods Forty-seven inpatients with confirmed COVID-19 had blood samples drawn on admission for assessing serum biomarkers of CNS injury by Single molecule array (Simoa), NfL and GFAp. Concentrations of NfL and GFAp were analyzed in relation to symptoms, clinical signs, inflammatory biomarkers and clinical outcomes. We used multivariate linear models to test for differences in biomarker concentrations in the subgroups, accounting for confounding effects.

Results In total, 21% (n = 10) of the patients were admitted to an intensive care unit, and the overall mortality rate was 13% (n = 6). Non-survivors had higher serum concentrations of NfL (p < 0.001) upon admission than patients who were discharged alive both in adjusted analyses (p = 2.6 × 10–7) and unadjusted analyses (p = 0.001). The concentrations of NfL in non-survivors increased over repeated measurements; whereas, the concentrations in survivors were stable. The GFAp concentration was also significantly higher in non-survivors than survivors (p = 0.02).

Conclusion Increased concentrations of NfL and GFAp in COVID-19 patients on admission may indicate increased mortality risk. Measurement of blood biomarkers for nervous system injury can be useful to detect and monitor CNS injury in COVID-19.