On 16 June, Dr. Nelly Kanberg and colleagues published an article in the Neurology journal, showing that COVID-19 may cause damage to the central nervous system (CNS).
While it is still unknown whether SARS-CoV2 (the coronavirus that causes COVID-19) can directly infect the brain, several lines of evidence now show that COVID-19 is associated with neuropathological changes in some affected groups. To examine the extent of CNS involvement in patients with COVID-19, the study authors set out to measure two established plasma biomarkers of CNS damage: neurofilament light chain (NfL; biomarker of neuronal injury) and glial fibrillary acidic protein (GFAP: biomarker of astrocyte injury).
The researchers analysed plasma samples from a total of 47 patients with COVID-19, 9 of whom had moderate symptoms (hospitalisation & oxygen supplementation) and 18 of whom were severely affected (requiring admission to intensive care and ventilation). None of the patients were affected by psychiatric or neurological disease, and samples were collected at presentation and again after a mean of 11 days after presentation.
Patients with severe COVID-19 had significantly higher plasma concentrations of NfL and GFAP compared to a control group. GFAP was also increased in patients with moderate COVID-19. In patients with severe COVID-19, levels of GFAP substantially decreased between the first and last samples taken, with the opposite pattern observed for NfL. Together, these results suggest that astrocyte damage may be a common feature in moderate and severe stages of COVID-19, while neuronal injury happens later in the disease course, in severely-affected patients. The authors concluded by stating that further studies in larger patient cohorts are now required, with longer follow-up and more extensive clinical phenotyping. Link to article:
https://n.neurology.org/content/early/2020/06/16/WNL.0000000000010111.long
