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Neurofilament light chain on intensive care admission is an independent predictor of mortality in COVID-19 : a prospective multicenter study

Sievert, Theodor LU orcid ; Didriksson, Ingrid LU orcid ; Spångfors, Martin LU orcid ; Lilja, Gisela LU ; Blennow, Kaj LU ; Zetterberg, Henrik LU ; Frigyesi, Attila LU and Friberg, Hans LU (2023) In Intensive Care Medicine Experimental 11(1).
Abstract

BACKGROUND: Neurofilament light chain (NfL), glial fibrillary acidic protein (GFAP), and total-tau protein (tau) are novel blood biomarkers of neurological injury, and may be used to predict outcomes in critical COVID-19.

METHODS: A prospective multicentre cohort study of 117 consecutive and critically ill COVID-19 patients in six intensive care units (ICUs) in southern Sweden between May and November 2020. Serial NfL, GFAP and tau were analysed in relation to mortality, the Glasgow Outcome Scale Extended (GOSE) and the physical (PCS) and mental (MCS) components of health-related quality of life at one year.

RESULTS: NfL, GFAP and tau on ICU admission predicted one-year mortality with an area under the curve (AUC) of 0.82... (More)

BACKGROUND: Neurofilament light chain (NfL), glial fibrillary acidic protein (GFAP), and total-tau protein (tau) are novel blood biomarkers of neurological injury, and may be used to predict outcomes in critical COVID-19.

METHODS: A prospective multicentre cohort study of 117 consecutive and critically ill COVID-19 patients in six intensive care units (ICUs) in southern Sweden between May and November 2020. Serial NfL, GFAP and tau were analysed in relation to mortality, the Glasgow Outcome Scale Extended (GOSE) and the physical (PCS) and mental (MCS) components of health-related quality of life at one year.

RESULTS: NfL, GFAP and tau on ICU admission predicted one-year mortality with an area under the curve (AUC) of 0.82 (95% confidence interval [CI] 0.74[Formula: see text]0.90), 0.72 (95% CI 0.62[Formula: see text]0.82) and 0.66 (95% CI 0.54[Formula: see text]0.77). NfL on admission was an independent predictor of one-year mortality (p = 0.039). Low NfL and GFAP values were associated with good PCS ([Formula: see text]45) at one year but not with good MCS ([Formula: see text]45) or GOSE ([Formula: see text]5).

CONCLUSIONS: NfL on ICU admission was an independent predictor of mortality. High levels of NfL, GFAP and tau were associated with mortality but not with poor GOSE in survivors at one year. Low levels of NfL and GFAP were associated with improved physical health-related quality of life.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Intensive Care Medicine Experimental
volume
11
issue
1
article number
66
publisher
Springer
external identifiers
  • scopus:85173095427
  • pmid:37768470
ISSN
2197-425X
DOI
10.1186/s40635-023-00547-x
language
English
LU publication?
yes
additional info
© 2023. European Society of Intensive Care Medicine and Springer Nature Switzerland AG.
id
d3272715-d9ce-4c7d-aa5b-8d4c5e6dedef
date added to LUP
2023-10-05 11:44:27
date last changed
2024-04-19 01:59:19
@article{d3272715-d9ce-4c7d-aa5b-8d4c5e6dedef,
  abstract     = {{<p>BACKGROUND: Neurofilament light chain (NfL), glial fibrillary acidic protein (GFAP), and total-tau protein (tau) are novel blood biomarkers of neurological injury, and may be used to predict outcomes in critical COVID-19.</p><p>METHODS: A prospective multicentre cohort study of 117 consecutive and critically ill COVID-19 patients in six intensive care units (ICUs) in southern Sweden between May and November 2020. Serial NfL, GFAP and tau were analysed in relation to mortality, the Glasgow Outcome Scale Extended (GOSE) and the physical (PCS) and mental (MCS) components of health-related quality of life at one year.</p><p>RESULTS: NfL, GFAP and tau on ICU admission predicted one-year mortality with an area under the curve (AUC) of 0.82 (95% confidence interval [CI] 0.74[Formula: see text]0.90), 0.72 (95% CI 0.62[Formula: see text]0.82) and 0.66 (95% CI 0.54[Formula: see text]0.77). NfL on admission was an independent predictor of one-year mortality (p = 0.039). Low NfL and GFAP values were associated with good PCS ([Formula: see text]45) at one year but not with good MCS ([Formula: see text]45) or GOSE ([Formula: see text]5).</p><p>CONCLUSIONS: NfL on ICU admission was an independent predictor of mortality. High levels of NfL, GFAP and tau were associated with mortality but not with poor GOSE in survivors at one year. Low levels of NfL and GFAP were associated with improved physical health-related quality of life.</p>}},
  author       = {{Sievert, Theodor and Didriksson, Ingrid and Spångfors, Martin and Lilja, Gisela and Blennow, Kaj and Zetterberg, Henrik and Frigyesi, Attila and Friberg, Hans}},
  issn         = {{2197-425X}},
  language     = {{eng}},
  month        = {{09}},
  number       = {{1}},
  publisher    = {{Springer}},
  series       = {{Intensive Care Medicine Experimental}},
  title        = {{Neurofilament light chain on intensive care admission is an independent predictor of mortality in COVID-19 : a prospective multicenter study}},
  url          = {{http://dx.doi.org/10.1186/s40635-023-00547-x}},
  doi          = {{10.1186/s40635-023-00547-x}},
  volume       = {{11}},
  year         = {{2023}},
}