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. 2021 Nov;268(11):3969-3974.
doi: 10.1007/s00415-021-10554-1. Epub 2021 Apr 23.

Serum neurofilament light chain (sNfL) values in a large cross-sectional population of children with asymptomatic to moderate COVID-19

Tobias Geis  1 , Susanne Brandstetter  1   2 , Antoaneta A Toncheva  1 , Otto Laub  3 , Georg Leipold  4 , Ralf Wagner  5 , Michael Kabesch  1   2 , Severin Kasser  6 , Jens Kuhle #  7 , Sven Wellmann #  8 ; CoKiBa Study group
Collaborators, Affiliations

Serum neurofilament light chain (sNfL) values in a large cross-sectional population of children with asymptomatic to moderate COVID-19

Tobias Geis et al. J Neurol. 2021 Nov.

Abstract

Background: 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.

Objective: To evaluate whether sNfL is elevated in children contracting COVID-19.

Methods: 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.

Results: 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.

Conclusions: In this population study, children with asymptomatic to moderate COVID-19 showed no neurochemical evidence of neuronal damage.

Keywords: Brain; COVID-19; Children; Neurofilament; Neurology.

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Conflict of interest statement

All authors declare that they have no competing financial or personal interests.

Figures

Fig. 1
Fig. 1
Association of SARS-CoV-2 antibody status (negative/positive) with sNfL. SARS-CoV-2 antibody status is not significantly associated with sNfL after adjusting for age and sex (linear regression analysis: B =  − 0.052, SE (B) = 0.030; P = .088. n = 2651)
Fig. 2
Fig. 2
Association of SARS-CoV-2 antibody levels with sNfL. Antibody levels in the Roche test (a; n = 130) and inhouse test (b; n = 147) are not significantly associated with sNfL after adjusting for age and sex [linear regression analysis: a B = 0.001, SE (B) = 0.001; P = .310. b B = 0.022, SE (B) = 0.015; P = .144]. Antibody levels: all participants with a positive test result > 1
See this image and copyright information in PMC

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