Researchers from Amsterdam UMC describe in Brain Communications the dynamics of neurofilament light in patients with COVID-19 in the intensive care unit (ICU). They also show associations with delirium, disease severity and markers of inflammation. They conclude that the study contributes to determining the clinical utility and interpretation of neurofilament light levels in IC patients.
Neurological monitoring in sedated patients in the ICU is limited by the lack of reliable blood biomarkers. Neurofilament light is a biomarker for neuronal damage with potential clinical utility for monitoring these patients. Patrick Smeele and colleagues studied developments in the neurofilament light values in IC patients with severe COVID-19 and examined the relationship with clinical outcomes and pathophysiological predictors. Data were collected during one month in 31 IC patients (166 plasma samples) with severe COVID-19 at Amsterdam UMC, and in the first week after emergency room admission from 297 patients with COVID-19 (635 plasma samples) at Massachusetts General hospital.
The researchers observed that neurofilament light increased nonlinearly in the first month of IC admission and increased more rapidly in the first week of IC admission compared to mild to moderate COVID-19 cases. The neurofilament light value at baseline did not predict mortality when adjusted for age and renal function. The peak neurofilament light value was associated with a longer duration of delirium after extubation in ICU patients. Disease severity, as measured by the SOFA score, was associated with higher neurofilament light values; and TNF-alpha levels at baseline were associated with higher levels of neurofilament light at baseline and a faster rise during admission.
Bron:
Smeele PJ, Vermunt L, Blok S, et al. Neurofilament light increases over time in severe COVID-19 and is associated with delirium. Brain Commun. 2022;4:fcac195.