Work

Neurochemical evidence of astrocytic and neuronal injury commonly found in COVID-19

Year: 2020

Type: article

Abstract: 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.

Source: Neurology

DOI: 10.1212/wnl.0000000000010111