Serum neurofilament light chain (sNfL) values in a large cross-sectional population of children with asymptomatic to moderate COVID-19

• Published in: Journal of neurology Vol. 268; no. 11; pp. 3969 - 3974
• Main Authors: Geis, Tobias, Brandstetter, Susanne, Toncheva, Antoaneta A., Laub, Otto, Leipold, Georg, Wagner, Ralf, Kabesch, Michael, Kasser, Severin, Kuhle, Jens, Wellmann, Sven
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.11.2021; Springer Nature B.V
• Subjects: Adult; Antibodies; Asymptomatic; Child; Children; Coronaviruses; COVID-19; Cross-Sectional Studies; Humans; Inflammation; Intermediate Filaments; Medicine; Medicine & Public Health; Neurofilament Proteins; Neurological diseases; Neurology; Neuroradiology; Neurosciences; Olfaction; Original Communication; Pandemics; Pediatrics; Population studies; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Systemic Inflammatory Response Syndrome; Bavaria Germany; Germany; COVID-19; Brain; Neurology; Neurofilament; Children
• ISSN: 0340-5354; 1432-1459
• DOI: 10.1007/s00415-021-10554-1

Background Serum neurofilament light chain (sNfL) is an established biomarker of neuro-axonal damage in multiple neurological disorders. Raised sNfL levels have been reported in adults infected with pandemic coronavirus disease 2019 (COVID-19). Levels in children infected with COVID-19 have not as yet been reported. Objective To evaluate whether sNfL is elevated in children contracting COVID-19. Methods Between May 22 and July 22, 2020, a network of outpatient pediatricians in Bavaria, Germany, the Coronavirus antibody screening in children from Bavaria study network (CoKiBa), recruited healthy children into a cross-sectional study from two sources: an ongoing prevention program for 1–14 years, and referrals of 1–17 years consulting a pediatrician for possible infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We determined sNfL levels by single molecule array immunoassay and SARS-CoV-2 antibody status by two independent quantitative methods. Results Of the 2652 included children, 148 (5.6%) were SARS-CoV-2 antibody positive with asymptomatic to moderate COVID-19 infection. Neurological symptoms—headache, dizziness, muscle aches, or loss of smell and taste—were present in 47/148 cases (31.8%). Mean sNfL levels were 5.5 pg/ml (SD 2.9) in the total cohort, 5.1 (SD 2.1) pg/ml in the children with SARS-CoV-2 antibodies, and 5.5 (SD 3.0) pg/ml in those without. Multivariate regression analysis revealed age—but neither antibody status, antibody levels, nor clinical severity—as an independent predictor of sNfL. Follow-up of children with pediatric multisystem inflammatory syndrome ( n  = 14) showed no association with sNfL. Conclusions In this population study, children with asymptomatic to moderate COVID-19 showed no neurochemical evidence of neuronal damage.