入院时的血液神经丝轻链和总 tau 水平可预测 COVID-19 患者的死亡。
Blood neurofilament light chain and total tau levels at admission predict death in COVID-19 patients.
机构信息
Division of Immunology, Transplantation and Infectious Diseases, IRCCS Ospedale San Raffaele, Milan, Italy.
Vita-Salute San Raffaele University, Milan, Italy.
出版信息
J Neurol. 2021 Dec;268(12):4436-4442. doi: 10.1007/s00415-021-10595-6. Epub 2021 May 10.
BACKGROUND AND AIMS
Patients infected with SARS-CoV-2 range from asymptomatic, to mild, moderate or severe disease evolution including fatal outcome. Thus, early predictors of clinical outcome are highly needed. We investigated markers of neural tissue damage as a possible early sign of multisystem involvement to assess their clinical prognostic value on survival or transfer to intensive care unit (ICU).
METHODS
We collected blood from 104 patients infected with SARS-CoV-2 the day of admission to the emergency room and measured blood neurofilament light chair (NfL), glial fibrillary acidic protein (GFAP), ubiquitin carboxy-terminal hydrolase L1 (UCH-L1), and total tau protein levels.
RESULTS
We found that NfL, GFAP, and tau were significantly increased in patients with fatal outcome, while NfL and UCH-L1 in those needing ICU transfer. ROC and Kaplan-Meier curves indicated that total tau levels at admission accurately predict mortality.
CONCLUSIONS
Blood neural markers may provide additional prognostic value to conventional biomarkers used to predict COVID-19 outcome.
背景与目的
感染 SARS-CoV-2 的患者病情从无症状到轻症、中症或重症不等，包括致命结局。因此，非常需要能够早期预测临床结局的指标。我们研究了神经组织损伤标志物作为多系统受累的早期迹象，以评估其对生存或转入重症监护病房（ICU）的临床预后价值。
方法
我们在急诊室收治当天采集了 104 名感染 SARS-CoV-2 的患者的血液，并测量了血液神经丝轻链（NfL）、胶质纤维酸性蛋白（GFAP）、泛素羧基末端水解酶 L1（UCH-L1）和总tau 蛋白水平。
结果
我们发现死亡患者的 NfL、GFAP 和 tau 明显升高，而需要 ICU 转科的患者的 NfL 和 UCH-L1 升高。ROC 和 Kaplan-Meier 曲线表明，入院时的总 tau 水平可准确预测死亡率。
结论
血液神经标志物可能为用于预测 COVID-19 结局的常规生物标志物提供额外的预后价值。
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