Journal of Neurology | May 10, 2021

De Lorenzo R, Loré NI, Finardi A, Mandelli A, Cirillo DM, Tresoldi C, Benedetti F, Ciceri F, Rovere-Querini P, Comi G, Filippi M, Manfredi AA and Furlan R

J Neurol. 2021:1-7

DOI: https://doi.org/10.1007/s00415-021-10595-6

Abstract

Background and aims

Patients infected with SARS-CoV-2 range from asymptomatic, to mild, moderate or severe disease evolution including fatal outcome. Thus, early predictors of clinical outcome are highly needed. We investigated markers of neural tissue damage as a possible early sign of multisystem involvement to assess their clinical prognostic value on survival or transfer to intensive care unit (ICU).

Methods

We collected blood from 104 patients infected with SARS-CoV-2 the day of admission to the emergency room and measured blood neurofilament light chair (NfL), glial fibrillary acidic protein (GFAP), ubiquitin carboxy-terminal hydrolase L1 (UCH-L1), and total tau protein levels.

Results

We found that NfL, GFAP, and tau were significantly increased in patients with fatal outcome, while NfL and UCH-L1 in those needing ICU transfer. ROC and Kaplan–Meier curves indicated that total tau levels at admission accurately predict mortality.

Conclusions

Blood neural markers may provide additional prognostic value to conventional biomarkers used to predict COVID-19 outcome.