University Children's Hospital Regensburg (KUNO), Hospital St. Hedwig of the Order of St. John, University of Regensburg, Steinmetzstr. 1-3, 93049, Regensburg, Germany.
Research and Development Campus Regensburg (WECARE), at the Hospital St. Hedwig of the Order of St. John, University of Regensburg, Regensburg, Germany.
J Neurol. 2021 Nov;268(11):3969-3974. doi: 10.1007/s00415-021-10554-1. Epub 2021 Apr 23.
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.
To evaluate whether sNfL is elevated in children contracting COVID-19.
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.
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.
In this population study, children with asymptomatic to moderate COVID-19 showed no neurochemical evidence of neuronal damage.
血清神经丝轻链（sNfL）是多种神经疾病中神经轴突损伤的一种既定生物标志物。有报道称，感染大流行冠状病毒病 2019（COVID-19）的成年人血清 sNfL 水平升高。尚未报道感染 COVID-19 的儿童的 sNfL 水平。
评估感染 COVID-19 的儿童 sNfL 是否升高。
2020 年 5 月 22 日至 7 月 22 日，德国巴伐利亚州的一个门诊儿科医生网络，即巴伐利亚州冠状病毒抗体筛查儿童研究网络（CoKiBa），从两个来源招募健康儿童进行横断面研究：正在进行的 1-14 岁预防计划和 1-17 岁因疑似感染严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）而咨询儿科医生的转诊。我们通过单分子阵列免疫测定法测定 sNfL 水平，并通过两种独立的定量方法测定 SARS-CoV-2 抗体状态。
在纳入的 2652 名儿童中，有 148 名（5.6%）儿童 SARS-CoV-2 抗体呈阳性，伴有无症状至中度 COVID-19 感染。47/148 例（31.8%）存在神经系统症状-头痛、头晕、肌肉疼痛或嗅觉和味觉丧失。总队列中 sNfL 水平的平均值为 5.5pg/ml（SD 2.9），SARS-CoV-2 抗体组为 5.1（SD 2.1）pg/ml，无抗体组为 5.5（SD 3.0）pg/ml。多变量回归分析显示，年龄-而非抗体状态、抗体水平或临床严重程度-是 sNfL 的独立预测因子。对儿科多系统炎症综合征患儿（n=14）的随访未发现与 sNfL 相关。
在这项人群研究中，无症状至中度 COVID-19 的儿童没有神经化学上神经元损伤的证据。
