Serum neurofilament light chain in COVID-19 and the influence of renal function
Abstract COVID-19 is associated with various neurological symptoms. Serum neurofilament light chain (sNfL) is a robust marker for neuroaxonal injury. Recent studies have shown that elevated levels of sNfL are associated with unfavorable outcome in COVID-19 patients. However, neuroaxonal injury is ra...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-09-01
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| Series: | European Journal of Medical Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40001-023-01375-1 |
| _version_ | 1827723873592803328 |
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| author | Peter Körtvelyessy Elena Diekämper Klemens Ruprecht Matthias Endres Paula Stubbemann Florian Kurth Jan Adriaan Graw Mario Menk Jens Kuhle Felix Wohlrab |
| author_facet | Peter Körtvelyessy Elena Diekämper Klemens Ruprecht Matthias Endres Paula Stubbemann Florian Kurth Jan Adriaan Graw Mario Menk Jens Kuhle Felix Wohlrab |
| author_sort | Peter Körtvelyessy |
| collection | DOAJ |
| description | Abstract COVID-19 is associated with various neurological symptoms. Serum neurofilament light chain (sNfL) is a robust marker for neuroaxonal injury. Recent studies have shown that elevated levels of sNfL are associated with unfavorable outcome in COVID-19 patients. However, neuroaxonal injury is rare in COVID-19, and renal dysfunction and hypoxia, both of which are known in severe COVID-19, can also increase sNfL levels. Thus, the meaning and mechanisms of sNfL elevation in COVID-19 patients remain unclear. We evaluated sNfL levels in 48 patients with COVID-19 (mean age = 63 years) and correlated them to clinical outcome, the form of oxygen therapy, and creatinine. Levels of sNfL were age adjusted and compared with normal values and z-scores. COVID-19 patients treated with nasal cannula had normal sNfL levels (mean sNfL = 19.6 pg/ml) as well as patients with high-flow treatment (mean sNfL = 40.8 pg/ml). Serum NfL levels were statistically significantly higher in COVID-19 patients treated with mechanical ventilation on intensive care unit (ICU) (mean sNfL = 195.7 pg/ml, p < 0.01). There was a strong correlation between sNfL elevation and unfavorable outcome in COVID-19 patients (p < 0.01). However, serum creatinine levels correlated directly and similarly with sNfL elevation and with unfavorable outcome in COVID-19 patients (p < 0.01). Additionally, multivariate analysis for serum creatinine and sNfL showed that both variables are jointly associated with clinical outcomes. Our results identify renal dysfunction as an important possible confounder for sNfL elevation in COVID-19. Thus, serum creatinine and renal dysfunction should be strongly considered in studies evaluating sNfL as a biomarker in COVID-19. |
| first_indexed | 2024-03-10T22:06:54Z |
| format | Article |
| id | doaj.art-f273d3422f4f494ab0ce4280f80aa433 |
| institution | Directory Open Access Journal |
| issn | 2047-783X |
| language | English |
| last_indexed | 2024-03-10T22:06:54Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | European Journal of Medical Research |
| spelling | doaj.art-f273d3422f4f494ab0ce4280f80aa4332023-11-19T12:47:15ZengBMCEuropean Journal of Medical Research2047-783X2023-09-012811710.1186/s40001-023-01375-1Serum neurofilament light chain in COVID-19 and the influence of renal functionPeter Körtvelyessy0Elena Diekämper1Klemens Ruprecht2Matthias Endres3Paula Stubbemann4Florian Kurth5Jan Adriaan Graw6Mario Menk7Jens Kuhle8Felix Wohlrab9Department of Neurology, Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu BerlinGerman Center for Neurodegenerative Diseases (DZNE) in MagdeburgDepartment of Neurology, Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu BerlinDepartment of Neurology, Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu BerlinDepartment of Pneumology, Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu BerlinDepartment of Pneumology, Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu BerlinDepartment of Anaesthesiology and Operative Intensive Care Medicine, Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu BerlinDepartment of Anaesthesiology and Operative Intensive Care Medicine, Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu BerlinMS Center, Neurology and Research Center for Clinical Neuroimmunology and Neuroscience Basel, University Hospital and University BaselDepartment of Neurology, Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu BerlinAbstract COVID-19 is associated with various neurological symptoms. Serum neurofilament light chain (sNfL) is a robust marker for neuroaxonal injury. Recent studies have shown that elevated levels of sNfL are associated with unfavorable outcome in COVID-19 patients. However, neuroaxonal injury is rare in COVID-19, and renal dysfunction and hypoxia, both of which are known in severe COVID-19, can also increase sNfL levels. Thus, the meaning and mechanisms of sNfL elevation in COVID-19 patients remain unclear. We evaluated sNfL levels in 48 patients with COVID-19 (mean age = 63 years) and correlated them to clinical outcome, the form of oxygen therapy, and creatinine. Levels of sNfL were age adjusted and compared with normal values and z-scores. COVID-19 patients treated with nasal cannula had normal sNfL levels (mean sNfL = 19.6 pg/ml) as well as patients with high-flow treatment (mean sNfL = 40.8 pg/ml). Serum NfL levels were statistically significantly higher in COVID-19 patients treated with mechanical ventilation on intensive care unit (ICU) (mean sNfL = 195.7 pg/ml, p < 0.01). There was a strong correlation between sNfL elevation and unfavorable outcome in COVID-19 patients (p < 0.01). However, serum creatinine levels correlated directly and similarly with sNfL elevation and with unfavorable outcome in COVID-19 patients (p < 0.01). Additionally, multivariate analysis for serum creatinine and sNfL showed that both variables are jointly associated with clinical outcomes. Our results identify renal dysfunction as an important possible confounder for sNfL elevation in COVID-19. Thus, serum creatinine and renal dysfunction should be strongly considered in studies evaluating sNfL as a biomarker in COVID-19.https://doi.org/10.1186/s40001-023-01375-1COVID-19Neurofilament light chainCreatinineBiomarker |
| spellingShingle | Peter Körtvelyessy Elena Diekämper Klemens Ruprecht Matthias Endres Paula Stubbemann Florian Kurth Jan Adriaan Graw Mario Menk Jens Kuhle Felix Wohlrab Serum neurofilament light chain in COVID-19 and the influence of renal function European Journal of Medical Research COVID-19 Neurofilament light chain Creatinine Biomarker |
| title | Serum neurofilament light chain in COVID-19 and the influence of renal function |
| title_full | Serum neurofilament light chain in COVID-19 and the influence of renal function |
| title_fullStr | Serum neurofilament light chain in COVID-19 and the influence of renal function |
| title_full_unstemmed | Serum neurofilament light chain in COVID-19 and the influence of renal function |
| title_short | Serum neurofilament light chain in COVID-19 and the influence of renal function |
| title_sort | serum neurofilament light chain in covid 19 and the influence of renal function |
| topic | COVID-19 Neurofilament light chain Creatinine Biomarker |
| url | https://doi.org/10.1186/s40001-023-01375-1 |
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