深入了解神经新冠:神经丝轻链(NfL)作为新冠后嗅觉功能障碍患者的生物标志物
Insight into NeuroCOVID: neurofilament light chain (NfL) as a biomarker in post-COVID-19 patients with olfactory dysfunctions.
作者信息
Pennacchia Fiorenza, Zoccali Federica, Petrella Carla, Talarico Giuseppina, Rusi Eqrem, Zingaropoli Maria Antonella, Ruqa Wael Abu, Bruno Giuseppe, Capuano Rosamaria, Catini Alexandro, Di Natale Corrado, Minni Antonio, Barbato Christian
机构信息
Department of Sense Organs, Sapienza University of Rome, Policlinico Umberto I, 00161, Rome, Italy.
Division of Otolaryngology-Head and Neck Surgery, ASL Rieti-Sapienza University, Ospedale San Camillo de Lellis, 02100, Rieti, Italy.
出版信息
J Neurol. 2025 Jul 1;272(7):484. doi: 10.1007/s00415-025-13222-w.
The term NeuroCOVID was coined to describe the neurological consequences observed in COVID-19 patients. Numerous patients infected with SARS-CoV-2 reported olfactory dysfunction as the first symptom preceding clinical manifestations, such as cough and fever, or even the only symptom, suggesting the sudden loss of smell or hyposmia as an important predictive factor for COVID-19 infection. Several patients developed long-term olfactory impairment, but to date there is not available a biochemical diagnosis of anosmia. The aim of this pilot study is to investigate the association between neurofilament light-chain (NfL) serum levels and the olfactory dysfunctions in post-COVID-19 patients. This study recruited patients who developed COVID-19 between January 2020 and August 2021. They were evaluated between October 2022 and March 2023 by Sniffin' Sticks tests to investigate deficits of odor identification, discrimination, and threshold and serum NfL biomarker measurement to assess a neuronal damage. Out of 27 patients, 11 were affected by post-viral permanent olfactory dysfunction (named Od-post-COVID-19) and 16 healed from the infection without residual Od problem, as a control group. We observed an increased levels of NfL 16.02 ± 1.91 pg/mL in Od-post-COVID-19, suggesting that NfL to be recognized as a biomarker of post-viral olfactory dysfunction, supporting the diagnostic process of NeuroCOVID, joined with other well-known neurological biomarkers and/or innovative investigative approaches.
“神经新冠”(NeuroCOVID)一词是为描述在新冠病毒感染患者中观察到的神经学后果而创造的。许多感染严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的患者报告嗅觉功能障碍是咳嗽和发热等临床表现之前的首个症状,甚至是唯一症状,这表明嗅觉突然丧失或嗅觉减退是新冠病毒感染的一个重要预测因素。一些患者出现了长期嗅觉障碍,但迄今为止尚无嗅觉丧失的生化诊断方法。这项初步研究的目的是调查新冠康复患者血清中神经丝轻链(NfL)水平与嗅觉功能障碍之间的关联。本研究招募了在2020年1月至2021年8月期间感染新冠病毒的患者。在2022年10月至2023年3月期间,通过“嗅棒”测试评估他们的气味识别、辨别和阈值缺陷,并测量血清NfL生物标志物以评估神经元损伤。在27名患者中,11名受病毒后永久性嗅觉功能障碍(称为新冠后嗅觉障碍,Od-post-COVID-19)影响,16名感染康复且无残留嗅觉问题,作为对照组。我们观察到新冠后嗅觉障碍患者的NfL水平升高至16.02±1.91 pg/mL,这表明NfL可被视为病毒后嗅觉功能障碍的生物标志物,与其他知名神经生物标志物和/或创新研究方法一起,支持神经新冠的诊断过程。