033-23 – Assessment of serum neurodegenerative and immune biomarkers in hospitalised COVID-19 patients

Neurological complications affect a significant number of hospitalised COVID-19 patients. The exact mechanism of SARS-CoV-2 CNS involvement is still elusive but recent literature points towards an uncontrolled immunological response, as increased levels of inflammatory and neurodegenerative biomarkers have been reported in hospitalised COVID-19 patients and active viral replication is rarely seen in brain tissues. High levels of biomarkers of neuroaxonal damage have been reported at the acute phase and some remain persistently raised for months after infection indicating their prognostic potential. Determining such biomarkers is vital to direct early neurological preventative treatment.
The main aims of the study are to determine prognostic biomarkers for COVID-19 neurological complications and provide information to help elucidate the mechanism of neurological complications of COVID-19.
The study will assess four neurodegenerative biomarkers, neurofilament light chain (NfL), glial fibrillary acidic protein (GFAP), ubiquitin carboxyl-terminal hydrolase L1 (UCH-L1) and total Tau, and 48 cytokines/chemokines in 806 biobank serum samples collected from hospitalised COVID-19 patients with or without neurological complications. Neurodegenerative biomarkers will be assessed using the Neurology 4-Plex assay and immune biomarkers will be assessed using the Bio-Plex Pro Human cytokine assay -48Plex. The study will also compare levels of phosphorylated tau-181 and amyloid beta (Aβ) 40 and 42 in a subset of COVID-19 patients with cognitive deficits and without any cognitive deficits. Results from this study will be analysed with available metadata including cognitive scores, MRI scans, neurological disorders, laboratory tests; D-Dimmers, creatinine, ferritin, and CRP.
Preliminary results showed significantly higher Tau and NfL levels in COVID-19 patients with neurological complications (cases) compared to COVID-19 patients with no neurological complications (controls).