Abstract
Neurofilament light chain (NfL) is a specific biomarker of neuro-axonal damage. Matrix metalloproteinases (MMPs) are zinc-dependent enzymes involved in blood-brain barrier (BBB) integrity. We explored neuro-axonal damage, alteration of BBB integrity and SARS-CoV-2 RNA presence in COVID-19 patients with severe neurological symptoms (neuro-COVID) as well as neuro-axonal damage in COVID-19 patients without severe neurological symptoms according to disease severity and after recovery, comparing the obtained findings with healthy donors (HD). Overall, COVID-19 patients ( n = 55) showed higher plasma NfL levels compared to HD ( n = 31) ( p < 0.0001), especially those who developed ARDS ( n = 28) ( p = 0.0005). After recovery, plasma NfL levels were still higher in ARDS patients compared to HD ( p = 0.0037). In neuro-COVID patients ( n = 12), higher CSF and plasma NfL, and CSF MMP-2 levels in ARDS than non-ARDS group were observed ( p = 0.0357, p = 0.0346 and p = 0.0303, respectively). SARS-CoV-2 RNA was detected in four CSF and two plasma samples. SARS-CoV-2 RNA detection was not associated to increased CSF NfL and MMP levels. During COVID-19, ARDS could be associated to CNS damage and alteration of BBB integrity in the absence of SARS-CoV-2 RNA detection in CSF or blood. CNS damage was still detectable after discharge in blood of COVID-19 patients who developed ARDS during hospitalization.
Keywords: MMPs; NfL; ddPCR; long-COVID; matrix metalloproteinases; neuro-COVID; neurofilament light chain; zymography.
【저자키워드】 ddPCR, long-COVID, matrix metalloproteinases, neuro-COVID, NfL, neurofilament light chain, MMPs, zymography., 【초록키워드】 COVID-19, Zinc, ARDS, Biomarker, Hospitalization, disease severity, discharge, Patient, blood-brain barrier, plasma, long-COVID, SARS-CoV-2 RNA, Neurological symptoms, matrix metalloproteinases, CNS, COVID-19 patients, Blood, CSF, neurofilament, SARS-CoV-2 RNA detection, COVID-19 patient, light chain, matrix, healthy donors, enzyme, alteration, plasma samples, ARDS patients, metalloproteinase, Neurological symptom, healthy donor, zymography, involved, detectable, absence, ARDS patient, 【제목키워드】 COVID-19, barrier, damage, integrity,