@article{a4e9db5dea934cf6ba9ef88bd952e6b2,
title = "Neurofilament light increases over time in severe COVID-19 and is associated with delirium",
abstract = "Neurological monitoring in sedated Intensive Care Unit patients is constrained by the lack of reliable blood-based biomarkers. Neurofilament light is a cross-disease biomarker for neuronal damage with potential clinical applicability for monitoring Intensive Care Unit patients. We studied the trajectory of neurofilament light over a month in Intensive Care Unit patients diagnosed with severe COVID-19 and explored its relation to clinical outcomes and pathophysiological predictors. Data were collected over a month in 31 Intensive Care Unit patients (166 plasma samples) diagnosed with severe COVID-19 at Amsterdam University Medical Centre, and in the first week after emergency department admission in 297 patients with COVID-19 (635 plasma samples) admitted to Massachusetts General hospital. We observed that Neurofilament light increased in a non-linear fashion in the first month of Intensive Care Unit admission and increases faster in the first week of Intensive Care Unit admission when compared with mild-moderate COVID-19 cases. We observed that baseline Neurofilament light did not predict mortality when corrected for age and renal function. Peak neurofilament light levels were associated with a longer duration of delirium after extubation in Intensive Care Unit patients. Disease severity, as measured by the sequential organ failure score, was associated to higher neurofilament light values, and tumour necrosis factor alpha levels at baseline were associated with higher levels of neurofilament light at baseline and a faster increase during admission. These data illustrate the dynamics of Neurofilament light in a critical care setting and show associations to delirium, disease severity and markers for inflammation. Our study contributes to determine the clinical utility and interpretation of neurofilament light levels in Intensive Care Unit patients. ",
keywords = "COVID-19, SOFA, TNF-α, delirium, neurofilament light",
author = "{Amsterdam UMC Covid-19 Biobank} and Smeele, {Patrick J.} and Lisa Vermunt and Siebe Blok and Duitman, {Jan Willem} and Nossent, {Esther J.} and {Van Agtmael}, {Michiel A.} and Heunks, {Leo M.A.} and Janneke Horn and Bogaard, {Harm Jan} and Teunissen, {Charlotte E.} and {Van Agtmael}, Michiel and Algera, {Anne Geke} and Brent Appelman and {Van Baarle}, Frank and Diane Bax and Martijn Beudel and Marije Bomers and Peter Bonta and Lieuwe Bos and Michela Botta and {De Brabander}, Justin and {De Bree}, Godelieve and {De Bruin}, Sanne and Buis, {David T.P.} and Marianna Bugiani and Esther Bulle and Nora Chekrouni and Osoul Chouchane and Alex Cloherty and Mirjam Dijkstra and Dongelmans, {Dave A.} and Erik Duijvelaar and Dujardin, {Romein W.G.} and Paul Elbers and Lucas Fleuren and Suzanne Geerlings and Theo Geijtenbeek and Armand Girbes and Bram Goorhuis and Grobusch, {Martin P.} and Florianne Hafkamp and Laura Hagens and Jorg Hamann and Vanessa Harris and Robert Hemke and Hermans, {Sabine M.} and {De Jong}, {Menno D.} and Patrick Thoral and Tuinman, {Pieter R.} and {De Vries}, Heder and Markus Hollmann and Hovius, {Joppe W.} and Rutger Koning and Lim, {Endry H. T.} and {van Mourik}, Niels and Frederique Paulus and Pina-Fuentes, {Dan A. I.} and {van der Poll}, Tom and Jorinde Raasveld and Tom Reijnders and {de Rotte}, {Maurits C. F. J.} and Schippers, {Job R.} and Michiel Schinkel and Schultz, {Marcus J.} and Schrauwen, {Femke A. P.} and Jaap Schuurmans and Kim Sigaloff and Slim, {Marleen A.} and Marry Smit and Stijnis, {Cornelis S.} and Willemke Stilma and Tsonas, {Anissa M.} and {van der Valk}, Marc and Denise Veelo and Carolien Volleman and {van Vugt}, Mich{\'e}le and Zwinderman, {A. H.} and Brouwer, {Matthijs C.} and Wiersinga, {W. Joost} and Vlaar, {Alexander P. J.} and {van de Beek}, Diederik",
note = "Funding Information: This study was funded by the Amsterdam University Medical Centers Corona Fund. Funders had no role in the in study design, data collection, data analyses, interpretation, or writing of this report. Publisher Copyright: {\textcopyright} 2022 The Author(s).",
year = "2022",
month = jul,
day = "26",
doi = "https://doi.org/10.1093/braincomms/fcac195",
language = "English",
volume = "4",
journal = "Brain Communications",
issn = "2632-1297",
publisher = "Oxford University Press",
number = "4",
}