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Neurofilament light increases over time in severe COVID-19 and is associated with delirium.
Smeele, Patrick J; Vermunt, Lisa; Blok, Siebe; Duitman, Jan Willem; Nossent, Esther J; van Agtmael, Michiel A; Heunks, Leo M A; Horn, Janneke; Bogaard, Harm Jan; Teunissen, Charlotte E.
  • Smeele PJ; Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands.
  • Vermunt L; Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands.
  • Blok S; Department of Pulmonary Medicine, Amsterdam University Medical Centre, Amsterdam 1081 HV, the Netherlands.
  • Duitman JW; Department of Pulmonary Medicine, Amsterdam University Medical Centre, Amsterdam 1081 HV, the Netherlands.
  • Nossent EJ; Department of Pulmonary Medicine, Amsterdam University Medical Centre, Amsterdam 1081 HV, the Netherlands.
  • van Agtmael MA; Department of Internal Medicine, Amsterdam University Medical Centre, Amsterdam 1081 HV, the Netherlands.
  • Heunks LMA; Department of Intensive Care Medicine, Amsterdam University Medical Centre, Amsterdam 1081 HV, the Netherlands.
  • Horn J; Department of Intensive Care Medicine, Amsterdam University Medical Centre, Amsterdam 1081 HV, the Netherlands.
  • Bogaard HJ; Department of Pulmonary Medicine, Amsterdam University Medical Centre, Amsterdam 1081 HV, the Netherlands.
  • Teunissen CE; Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands.
Brain Commun ; 4(4): fcac195, 2022.
Article in English | MEDLINE | ID: covidwho-1985044
ABSTRACT
Neurological monitoring in sedated Intensive Care Unit patients is constrained by the lack of reliable blood-based biomarkers. Neurofilament light is a cross-disease biomarker for neuronal damage with potential clinical applicability for monitoring Intensive Care Unit patients. We studied the trajectory of neurofilament light over a month in Intensive Care Unit patients diagnosed with severe COVID-19 and explored its relation to clinical outcomes and pathophysiological predictors. Data were collected over a month in 31 Intensive Care Unit patients (166 plasma samples) diagnosed with severe COVID-19 at Amsterdam University Medical Centre, and in the first week after emergency department admission in 297 patients with COVID-19 (635 plasma samples) admitted to Massachusetts General hospital. We observed that Neurofilament light increased in a non-linear fashion in the first month of Intensive Care Unit admission and increases faster in the first week of Intensive Care Unit admission when compared with mild-moderate COVID-19 cases. We observed that baseline Neurofilament light did not predict mortality when corrected for age and renal function. Peak neurofilament light levels were associated with a longer duration of delirium after extubation in Intensive Care Unit patients. Disease severity, as measured by the sequential organ failure score, was associated to higher neurofilament light values, and tumour necrosis factor alpha levels at baseline were associated with higher levels of neurofilament light at baseline and a faster increase during admission. These data illustrate the dynamics of Neurofilament light in a critical care setting and show associations to delirium, disease severity and markers for inflammation. Our study contributes to determine the clinical utility and interpretation of neurofilament light levels in Intensive Care Unit patients.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Prognostic study / Randomized controlled trials Language: English Journal: Brain Commun Year: 2022 Document Type: Article Affiliation country: Braincomms

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Prognostic study / Randomized controlled trials Language: English Journal: Brain Commun Year: 2022 Document Type: Article Affiliation country: Braincomms