Serum neurofilament light chain (sNfL) values in a large cross-sectional population of children with asymptomatic to moderate COVID-19

Abstract

Background Serum neurofilament light chain (sNfL) is an established biomarker of neuro-axonal damage in multiple neurological disorders. Raised sNfL levels have been reported in adults infected with pandemic coronavirus disease 2019 (COVID-19). Levels in children infected with COVID-19 have not as yet been reported. Objective To evaluate whether sNfL is elevated in children contracting COVID-19. Methods Between May 22 and July 22, 2020, a network of outpatient pediatricians in Bavaria, Germany, the Coronavirus antibody screening in children from Bavaria study network (CoKiBa), recruited healthy children into a cross-sectional study from two sources: an ongoing prevention program for 1–14 years, and referrals of 1–17 years consulting a pediatrician for possible infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We determined sNfL levels by single molecule array immunoassay and SARS-CoV-2 antibody status by two independent quantitative methods. Results Of the 2652 included children, 148 (5.6%) were SARS-CoV-2 antibody positive with asymptomatic to moderate COVID-19 infection. Neurological symptoms—headache, dizziness, muscle aches, or loss of smell and taste—were present in 47/148 cases (31.8%). Mean sNfL levels were 5.5 pg/ml (SD 2.9) in the total cohort, 5.1 (SD 2.1) pg/ml in the children with SARS-CoV-2 antibodies, and 5.5 (SD 3.0) pg/ml in those without. Multivariate regression analysis revealed age—but neither antibody status, antibody levels, nor clinical severity—as an independent predictor of sNfL. Follow-up of children with pediatric multisystem inflammatory syndrome (n = 14) showed no association with sNfL. Conclusions In this population study, children with asymptomatic to moderate COVID-19 showed no neurochemical evidence of neuronal damage.

Plasma Biomarkers of Neuropathogenesis in Hospitalized Patients With COVID-19 and Those With Postacute Sequelae of SARS-CoV-2 Infection

“…Our results confirm previously published findings that patients hospitalized with severe COVID-19 have elevated biomarkers of CNS injury in their blood. 6 , 21 - 25 This finding therefore supports the body of literature showing that COVID-19 neurologic sequelae in the acute phase are accompanied by damage to the CNS despite the fact that direct SARS-CoV-2 infection of the brain parenchyma remains a matter of debate. 26 In severely ill patients, the possible causes of CNS injury include hypoxemia, vasculopathy, coagulopathy, or systemic inflammation leading to blood-brain barrier disruption.…”

Serum glial fibrillary acidic protein and neurofilament light chain in patients with early treated phenylketonuria

“…No alterations of sNfL concentrations in ETPKU patients were found in this study. The negativ association of sNfL concentrations with age in children below 12 years of age and the positive association in adults were consistent with data from HC previously described (55, [67][68][69]. The sNfL concentrations in our ETPKU cohort were not elevated (37,72).…”

Neurofilament Light Chain Levels in Anti-NMDAR Encephalitis and Primary Psychiatric Psychosis

“…Otherwise, the NfL values of our control group when measured with the single-molecule array Quanterix (as recommended by the company) are similar to those reported by other investigators in healthy individuals of similar age range. 22,29,31-38…”