Prognostic performance of blood neurofilament light chain protein in hospitalized COVID-19 patients without major central nervous system manifestations: an individual participant data meta-analysis.

Autor: Abdelhak A; Department of Neurology, University of California San Francisco (UCSF), San Francisco, USA., Barba L; Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany., Romoli M; Department of Neuroscience, Neurology Unit, Maurizio Bufalini Hospital, AUSL Romagna, Cesena, Italy., Benkert P; Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland., Conversi F; Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy., D'Anna L; Department of Stroke and Neuroscience, Charing Cross Hospital, Imperial College London NHS Healthcare Trust, London, UK.; Department of Brain Sciences, Imperial College London, London SW7 2AZ, UK., Masvekar RR; Neuroimmunological Diseases Section, National Institute of Allergy and Infectious Diseases, National Institute of Health, Bethesda, MD, USA., Bielekova B; Neuroimmunological Diseases Section, National Institute of Allergy and Infectious Diseases, National Institute of Health, Bethesda, MD, USA., Prudencio M; Department of Neuroscience, Mayo Clinic, Jacksonville, FL, 32224, USA.; Neuroscience Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, FL, 32224, USA., Petrucelli L; Department of Neuroscience, Mayo Clinic, Jacksonville, FL, 32224, USA.; Neuroscience Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, FL, 32224, USA., Meschia JF; Department of Neurology, Mayo Clinic, Jacksonville, FL, 32224, USA., Erben Y; Division of Vascular and Endovascular Surgery, Mayo Clinic, Jacksonville, FL, 32224, USA., Furlan R; Institute of Experimental Neurology, Division of Neuroscience, IRCCS Ospedale San Raffaele, Milan, Italy.; Institute of Experimental Neurology, Division of Neuroscience, Vita e Salute San Raffaele University, Milan, Italy., De Lorenzo R; Division of Immunology, Transplantation and Infectious Diseases, IRCCS Ospedale San Raffaele, Milan, Italy., Mandelli A; Institute of Experimental Neurology, Division of Neuroscience, IRCCS Ospedale San Raffaele, Milan, Italy., Sutter R; Department of Acute Medical Care, Intensive Care Unit, University Hospital Basel, Basel, Switzerland., Hert L; Department of Acute Medical Care, Intensive Care Unit, University Hospital Basel, Basel, Switzerland., Epple V; Department of Neurology, University Hospital Basel and University of Basel, Basel, Switzerland., Marastoni D; Neurology B, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy., Sellner J; Department of Neurology, Landesklinikum Mistelbach-Gänserndorf, Mistelbach, Austria., Steinacker P; Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany., Aamodt AH; Department of Neurology, Oslo University Hospital, Oslo, Norway., Heggelund L; Department of Internal Medicine, Drammen Hospital, Vestre Viken Hospital Trust, Drammen, Norway.; Department of Clinical Science, Faculty of Medicine, University of Bergen, Bergen, Norway., Dyrhol-Riise AM; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.; Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway., Virhammar J; Department of Medical Sciences, Neurology, Uppsala University, Uppsala, Sweden., Fällmar D; Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden., Rostami E; Department of Medical Sciences, Uppsala University, Neurosurgery,, Sweden.; Department of Neuroscience, Karolinska Institute, Stockholm, Sweden., Kumlien E; Department of Medical Sciences, Neurology, Uppsala University, Uppsala, Sweden., Blennow K; Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden., Zetterberg H; Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.; Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK.; UK Dementia Research Institute at UCL, London, UK.; Hong Kong Center for Neurodegenerative Diseases, Clear Water Bay, Hong Kong, China.; Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, University of Wisconsin, University of Wisconsin-Madison, Madison, WI, USA., Tumani H; Department of Neurology, Ulm University Hospital, Ulm, Germany., Sacco S; Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy., Green AJ; Department of Neurology, University of California San Francisco (UCSF), San Francisco, USA., Otto M; Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany., Kuhle J; Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland.; Research Center for Clinical Neuroimmunology and Neuroscience (RC2NB), Departments of Biomedicine and Clinical Research, University Hospital and University of Basel, Basel, Switzerland.; Multiple Sclerosis Centre, Department of Neurology, University Hospital and University of Basel, Basel, Switzerland., Ornello R; Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy., Foschi M; Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy. mattfos89@gmail.com.; Department of Neuroscience, Neurology Unit, S.Maria Delle Croci Hospital of Ravenna, AUSL Romagna, Ravenna, Italy. mattfos89@gmail.com., Abu-Rumeileh S; Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany. samir.aburumeileh@gmail.com.
Jazyk: angličtina
Zdroj: Journal of neurology [J Neurol] 2023 Jul; Vol. 270 (7), pp. 3315-3328. Date of Electronic Publication: 2023 May 15.
DOI: 10.1007/s00415-023-11768-1
Abstrakt: Background and Aims: To investigate the prognostic value of blood neurofilament light chain protein (NfL) levels in the acute phase of coronavirus disease 2019 (COVID-19).
Methods: We conducted an individual participant data (IPD) meta-analysis after screening on MEDLINE and Scopus to May 23rd 2022. We included studies with hospitalized adult COVID-19 patients without major COVID-19-associated central nervous system (CNS) manifestations and with a measurement of blood NfL in the acute phase as well as data regarding at least one clinical outcome including intensive care unit (ICU) admission, need of mechanical ventilation (MV) and death. We derived the age-adjusted measures NfL Z scores and conducted mixed-effects modelling to test associations between NfL Z scores and other variables, encompassing clinical outcomes. Summary receiver operating characteristic curves (SROCs) were used to calculate the area under the curve (AUC) for blood NfL.
Results: We identified 382 records, of which 7 studies were included with a total of 669 hospitalized COVID-19 cases (mean age 66.2 ± 15.0 years, 68.1% males). Median NfL Z score at admission was elevated compared to the age-corrected reference population (2.37, IQR: 1.13-3.06, referring to 99th percentile in healthy controls). NfL Z scores were significantly associated with disease duration and severity. Higher NfL Z scores were associated with a higher likelihood of ICU admission, need of MV, and death. SROCs revealed AUCs of 0.74, 0.80 and 0.71 for mortality, need of MV and ICU admission, respectively.
Conclusions: Blood NfL levels were elevated in the acute phase of COVID-19 patients without major CNS manifestations and associated with clinical severity and poor outcome. The marker might ameliorate the performance of prognostic multivariable algorithms in COVID-19.
(© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)
Databáze: MEDLINE
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