Elevation of Neurodegenerative Serum Biomarkers among Hospitalized COVID-19 Patients

  1. Jennifer A. Frontera
  2. Allal Boutajangout
  3. Arjun V. Masurkar
  4. Rebecca A. Betensky
  5. Yulin Ge
  6. Alok Vedvyas
  7. Ludovic Debure
  8. Andre Moreira
  9. Ariane Lewis
  10. Joshua Huang
  11. Sujata Thawani
  12. Laura Balcer
  13. Steven Galetta
  14. Thomas Wisniewski
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Abstract

INTRODUCTION

Older adults hospitalized with COVID-19 are susceptible to neurological complications, particularly encephalopathy, which may reflect age-related neurodegenerative processes.

METHODS

Serum total tau, ptau-181, GFAP, NFL, UCHL1, and amyloid-beta(Aβ-40,42) were measured in hospitalized COVID-19 patients without a history of dementia, and compared among patients with or without encephalopathy, in-hospital death versus survival, and discharge home versus other dispositions using multivariable Cox proportional hazards regression analyses.

RESULTS

Among 251 patients, admission serum ptau-181 and UCHL1 were significantly elevated in patients with encephalopathy (both P<0.05) and total tau, GFAP, and NFL were significantly lower in those discharged home(all P<0.05). These markers correlated significantly with severity of COVID illness. NFL, GFAP and UCH-L1 were significantly higher in hospitalized COVID patients than in non-COVID controls with mild cognitive impairment or Alzheimer’s disease(AD).

DISCUSSION

Age-related neurodegenerative biomarkers were elevated to levels observed in AD and associated with encephalopathy and worse outcomes among hospitalized COVID-19 patients.

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