Neurological symptoms and neuronal damage markers in acute COVID-19: Is there a correlation? A pilot study

Abstract

A wide spectrum of neurological symptoms (NS) has been described in patients with COVID-19. We examined the plasma levels of neuron-specific enolase (NSE) and neurofilament light chain (NFL) together, as neuronal damage markers, and their relationships with clinical severity in patients with NS at acute COVID-19. A total of 20 healthy controls and 59 patients with confirmed COVID-19 were enrolled in this pilot prospective study. Serum NSE and NFL levels were measured by using the enzyme-linked immunoassay method from serum samples. Serum NSE levels were found to be significantly higher in the severe group than in the nonsevere group (p = 0.034). However, serum NFL levels were similar between the control and disease groups (p > 0.05). For the mild group, serum NFL levels were significantly higher in patients with the sampling time ≥5 days than in those with the sampling time <5 days (p = 0.019). However, no significant results for NSE and NFL were obtained in patients with either single or multiple NS across the groups (p > 0.05). Increased serum NSE levels were associated with disease severity regardless of accompanied NS in patients with acute COVID-19 infection. However, serum NFL levels may have a role at the subacute phase of COVID-19.

Keywords: COVID-19; neurofilament light chain; neurological symptoms; neuron-specific enolase; neuronal damage.

Figure 1

Box plot for neuron‐specific enolase (NSE) across COVID‐19 severity groups

Figure 2

ROC curve of NSE for discriminating mild + moderate versus severe COVID‐19 groups. NSE, neuron‐specific enolase; ROC, receiver operating characteristic.