Neurochemical evidence of astrocytic and neuronal injury commonly found in COVID-19
Artikel i vetenskaplig tidskrift, 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.


Nelly Kanberg

Sahlgrenska universitetssjukhuset

Nicholas J. Ashton

Sahlgrenska universitetssjukhuset

L. M. Andersson

Sahlgrenska universitetssjukhuset

Aylin Yilmaz

Sahlgrenska universitetssjukhuset

Magnus Lindh

Sahlgrenska universitetssjukhuset

Staffan Nilsson

Sahlgrenska universitetssjukhuset

Chalmers, Matematiska vetenskaper, Tillämpad matematik och statistik

Richard W. Price

Sahlgrenska universitetssjukhuset

Kaj Blennow

Sahlgrenska universitetssjukhuset

Henrik Zetterberg

Sahlgrenska universitetssjukhuset

Magnus Gisslen

Sahlgrenska universitetssjukhuset


00283878 (ISSN) 1526632X (eISSN)

Vol. 95 12 e1754-e1759


Klinisk laboratoriemedicin







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