Serum neurofilament light chain in COVID-19 and the influence of renal function
© 2023. The Author(s)..
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.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:28 |
|---|---|
| Enthalten in: |
European journal of medical research - 28(2023), 1 vom: 28. Sept., Seite 389 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Körtvelyessy, Peter [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
AYI8EX34EU |
|---|
| Anmerkungen: |
Date Completed 27.11.2023 Date Revised 27.11.2023 published: Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1186/s40001-023-01375-1 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM362671540 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM362671540 | ||
| 003 | DE-627 | ||
| 005 | 20231226091724.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1186/s40001-023-01375-1 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1208.xml |
| 035 | |a (DE-627)NLM362671540 | ||
| 035 | |a (NLM)37770938 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Körtvelyessy, Peter |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Serum neurofilament light chain in COVID-19 and the influence of renal function |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 27.11.2023 | ||
| 500 | |a Date Revised 27.11.2023 | ||
| 500 | |a published: Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023. The Author(s). | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Biomarker | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a Creatinine | |
| 650 | 4 | |a Neurofilament light chain | |
| 650 | 7 | |a Creatinine |2 NLM | |
| 650 | 7 | |a AYI8EX34EU |2 NLM | |
| 650 | 7 | |a Biomarkers |2 NLM | |
| 700 | 1 | |a Diekämper, Elena |e verfasserin |4 aut | |
| 700 | 1 | |a Ruprecht, Klemens |e verfasserin |4 aut | |
| 700 | 1 | |a Endres, Matthias |e verfasserin |4 aut | |
| 700 | 1 | |a Stubbemann, Paula |e verfasserin |4 aut | |
| 700 | 1 | |a Kurth, Florian |e verfasserin |4 aut | |
| 700 | 1 | |a Graw, Jan Adriaan |e verfasserin |4 aut | |
| 700 | 1 | |a Menk, Mario |e verfasserin |4 aut | |
| 700 | 1 | |a Kuhle, Jens |e verfasserin |4 aut | |
| 700 | 1 | |a Wohlrab, Felix |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t European journal of medical research |d 1998 |g 28(2023), 1 vom: 28. Sept., Seite 389 |w (DE-627)NLM090122402 |x 2047-783X |7 nnns |
| 773 | 1 | 8 | |g volume:28 |g year:2023 |g number:1 |g day:28 |g month:09 |g pages:389 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1186/s40001-023-01375-1 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 28 |j 2023 |e 1 |b 28 |c 09 |h 389 | ||