Neurochemical evidence of astrocytic and neuronal injury commonly found in COVID-19
Journal article, 2020

OBJECTIVE: To test the hypothesis that coronavirus disease 2019 (COVID-19) has an impact on the CNS by measuring plasma biomarkers of CNS injury. METHODS: We recruited 47 patients with mild (n = 20), moderate (n = 9), or severe (n = 18) COVID-19 and measured 2 plasma biomarkers of CNS injury by single molecule array, neurofilament light chain protein (NfL; a marker of intra-axonal neuronal injury) and glial fibrillary acidic protein (GFAp; a marker of astrocytic activation/injury), in samples collected at presentation and again in a subset after a mean of 11.4 days. Cross-sectional results were compared with results from 33 age-matched controls derived from an independent cohort. RESULTS: The patients with severe COVID-19 had higher plasma concentrations of GFAp (p = 0.001) and NfL (p < 0.001) than controls, while GFAp was also increased in patients with moderate disease (p = 0.03). In patients with severe disease, an early peak in plasma GFAp decreased on follow-up (p < 0.01), while NfL showed a sustained increase from first to last follow-up (p < 0.01), perhaps reflecting a sequence of early astrocytic response and more delayed axonal injury. CONCLUSION: We show neurochemical evidence of neuronal injury and glial activation in patients with moderate and severe COVID-19. Further studies are needed to clarify the frequency and nature of COVID-19-related CNS damage and its relation to both clinically defined CNS events such as hypoxic and ischemic events and mechanisms more closely linked to systemic severe acute respiratory syndrome coronavirus 2 infection and consequent immune activation, as well as to evaluate the clinical utility of monitoring plasma NfL and GFAp in the management of this group of patients.

Author

Nelly Kanberg

Sahlgrenska University Hospital

Nicholas J. Ashton

Sahlgrenska University Hospital

L. M. Andersson

Sahlgrenska University Hospital

Aylin Yilmaz

Sahlgrenska University Hospital

Magnus Lindh

Sahlgrenska University Hospital

Staffan Nilsson

Sahlgrenska University Hospital

Chalmers, Mathematical Sciences, Applied Mathematics and Statistics

Richard W. Price

Sahlgrenska University Hospital

Kaj Blennow

Sahlgrenska University Hospital

Henrik Zetterberg

Sahlgrenska University Hospital

Magnus Gisslen

Sahlgrenska University Hospital

Neurology

00283878 (ISSN) 1526632X (eISSN)

Vol. 95 12 e1754-e1759

Subject Categories

Clinical Laboratory Medicine

Gastroenterology and Hepatology

Neurology

DOI

10.1212/WNL.0000000000010111

PubMed

32546655

More information

Latest update

11/5/2020