Brain damage serum biomarkers induced by COVID-19 in patients from northeast Brazil

Abstract

Neurological symptoms have been often reported in COVID-19 disease. In the present study, we evaluated brain damage associated with the increase of serum levels of neurological biomarkers S100B and neuron-specific enolase (NSE) induced by SARS-CoV-2 infection, in a population from Northeastern Brazil. Thirty-six healthy control (G1) individuals and 141 patients with confirmed COVID-19 were enrolled in this study. Positive-COVID-19 patients were divided into two groups according to the severity of illness by the National Institute of Health (NIH) criteria, 76 patients with mild symptoms for COVID-19 and (G2) and 65 with acute respiratory conditions requiring supplemental oxygenation via intensive care unit (ICU) admission (G3). A follow-up study was conducted with 23 patients from G2 14 (D14) and 21 (D21) days after the onset of symptoms. Serum levels of NSE and S100B were measured using the enzyme-linked immunoassay method (ELISA). Results revealed a significant positive association between G3 patients and S100B serum expression ( p = 0.0403). The serum levels of NSE were also significantly enhanced in the G3 group compared to the control ( p < 0.0001) and G2 group ( p < 0.0001). In addition, clinical features such as symptoms and oxygenation status were not correlated with NSE or S100B serum expression. The follow-up study demonstrated a decrease over time (21 days) in NSE serum expression ( p < 0.0001). These results suggest that brain damage is followed by acute virus exposure, with no long-term effects. Future work examining COVID-19 recovery will shed light on chronic neurological damage of SARS-CoV-2 infection.

Blood Biomarkers as Prognostic Indicators for Neurological Injury in COVID-19 Patients: A Systematic Review and Meta-Analysis

“…Taken together, previous studies have reported changes in NfL and GFAP levels in COVID-19 patients [18,19,21,26,27]. However, some studies have reported contradictory findings [30][31][32], which warrant a comprehensive analysis of the relationship between neurological biomarkers (GFAP and NfL) and COVID-19. Therefore, this systematic review and meta-analysis aimed to determine the pooled standardized mean differences (SMD) of GFAP and NfL between COVID-19 patients and healthy controls, generating evidence for the association between neurological injury-related biomarkers and COVID-19 prognosis.…”

“…The full texts of the remaining 47 studies were reviewed, and 26 studies were subsequently excluded based on the eligibility criteria. Among the excluded studies, 15 did not report outcomes of interest (NfL and GFAP) in both COVID-19 and healthy controls [30,31,[38][39][40][41][42][43][44][45][46][47][48][49][50], six did not include healthy controls [31,36,38,44,48,51], three were reviews [8,52,53], and two were editorial reports [54,55]; note that a few reports belonged to more than one category. Finally, 21 studies that reported mean (±SD) or median (±IQR) values for NfL and GFAP were included in the meta-analysis (Figure 1).…”

Predictive Performance of Neuron-Specific Enolase (NSE) for Survival after Resuscitation from Cardiac Arrest: A Systematic Review and Meta-Analysis

“…Measurements were made between 1 and 3 days after cardiac arrest. In the cited cohort study, NfL was a biomarker that was particularly useful in predicting an unfavorable prognosis (death and significant functional impairment) one year after cardiac arrest [113][114][115]. NfL was also the subject of a recently published meta-analysis that demonstrated its particular utility in predicting neurological statuses when measured 72 h after cardiac arrest.…”

Neurovirulent cytokines increase neuronal excitability in a model of coronavirus-induced neuroinflammation

“…Neuroinflammation, identified by elevated levels of brain cytokines, occurs in COVID-19 and is associated with acute neurological disturbances, persistent structural changes, and severe disease [ 15 – 17 ]. Moreover, markers of neuronal injury such as neuron-specific enolase and S100B correlate with virulence in COVID-19 [ 18 , 19 ]. MHV-A59 brain infection elevates five proinflammatory cytokines: TNFα, IL-1β, IL-6, IL-12p40, and IL-15.…”