Serum Neurofilament Light Chain Levels in the Intensive Care Unit: Comparison between Severely Ill Patients with and without Coronavirus Disease 2019

There is emerging evidence for multifarious neurological manifestations of coronavirus disease 2019 (COVID-19), but little is known regarding whether they reflect structural damage to the nervous system. Serum neurofilament light chain (sNfL) is a specific biomarker of neuronal injury. We measured sNfL concentrations of 29 critically ill COVID-19 patients, 10 critically ill non-COVID-19 patients, and 259 healthy controls. After adjusting for neurological comorbidities and age, sNfL concentrations were higher in patients with COVID-19 versus both comparator groups. Higher sNfL levels were associated with unfavorable short-term outcome, indicating that neuronal injury is common and pronounced in critically ill patients.

Automated summary

There is increasing evidence for various neurological manifestations of COVID-19, with higher sNfL concentrations observed in critically ill patients with COVID-19 compared to healthy controls and critically ill non-COVID-19 patients. Elevated sNfL levels were associated with unfavorable short-term outcomes, indicating common and pronounced neuronal injury in critically ill patients.