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.
【저자키워드】 COVID-19, SARS-CoV-2, Mortality, Neurofilament light, Glial fibrillary acidic protein, 【초록키워드】 Biomarker, Biomarkers, intensive care, disease severity, intensive care unit, risk, Symptoms, clinical outcomes, Protein, serum, Patient, Adjusted analysis, nervous system, Clinical signs, serum biomarkers, CNS, Admission, GFAp, COVID-19 patients, Blood, Simoa, inflammatory biomarkers, Inflammatory biomarker, Concentration, Analysis, Injury, COVID-19 patient, on admission, light chain, Inpatient, Non-survivors, overall mortality, Blood samples, subgroups, blood sample, Acidic, serum concentrations, increased mortality, hypotheses, MONITOR, survivor, linear models, adjusted analyses, Linear model, repeated, Effects, measurement, objective, non-survivor, Result, analyzed, detect, the patient, significantly higher, discharged, hypothese, Increased, serum biomarker, 【제목키워드】 Prognostic marker, Concentration,