Serum neurofilament light chain (sNfL) values in a large cross-sectional population of children with asymptomatic to moderate COVID-19
Tobias Geis, Susanne Brandstetter, Antoaneta A. Toncheva, Otto Laub, Georg Leipold, Ralf Wagner, Michael Kabesch, Severin Kasser, Jens Kühle, Sven Wellmann, CoKiBa Study group, Bettina Aichholzer, Georg W. Mair, M Wruk, Imke Reischl, Andreas Ambrosch, David Antoš, Stephan von Koskull, Christian Becker, Elisabeth Beer, Hubert Schirmer, Georg Birkinger, Andreas Blueml, Heike Buntrock‐Döpke, Mona Castrop, Jost Dieckerhoff, Renate Eichhorn, Dominik Ewald, Gudrun Fleck Alfred Heihoff, Jürgen Geuder, Jens Grombach, Peter Gutdeutsch, Florian Segerer, Thomas Habash, Sonja Habash, Susanne Harner, Christoph Herbst, Daniela Heuschmann, Meike Hofmann, Michael Horn, Birgit Jork-Kaeferlein, Monika Schwarz, R. Hopfner, Guido Judex, Bastian Baumgartner, Monika Corbacioglu, Sabrina Lindner, Bettina Meinel, Alena Bauer, Hannes Löw, Annamaria Szulagyi-Kovacs, Sarah Laub, Annegret Klein, Cosima Koering, Niclas Landvogt, Claudia Soehngen, Karin Rasp, Gudrun Schick-Niedermeier, Marinus Laub, Otto Laub, Georg Leipold, Petra Schmid-Seibold, J Pawlak, M. Reitz, Georg Puchner, David Peterhoff, Christiane Razeghi, Stefan Razeghi, Christine Rehe, Klaus Rehe, Matthias Scheffel, Ludwig Kaesbauer, Roland M. Schmid, Michael Strobelt, Nina Schoetzau, A. Schweiger‐Kabesch, Marko Senjor, Michael Sperlich, Guenter Theuerer, Guenter Steidle, German Tretter, Victor von Arnim, Marlene Volz‐Fleckenstein, Sebastian Einhauser, Patrick Neckermann, Natascha Borchers, Elisangela Santos-Valente, Parastoo Kheiroddin, Patricia Schöberl, Jakob Niggel, Stephan Gerling
Abstract
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.