No serological evidence for neuronal damage or reactive gliosis in neuro-COVID-19 patients with long-term persistent headache
Laura de Boni, Alexandru Odainic, Natalie Gancarczyk, Luisa Kaluza, Christian P. Strassburg, Xenia A. K. Kersting, Joseph M. Johnson, Ullrich Wüllner, Susanne V. Schmidt, Jacob Nattermann, Gabor C. Petzold
Abstract
Recent studies have indicated that long-term neurological sequelae after COVID-19 are not accompanied by an increase of canonical biomarkers of central nervous system injury in blood, but subgroup stratifications are lacking. This is a particular concern in chronic headache, which can be a leading symptom of Post-COVID diseases associated with neuronal damage such as vasculitis or autoimmune encephalitis. We here compared patients with mild Post-COVID-19 syndrome and persistent headache (persistent Post-COVID-19 headache) lasting longer than 12 weeks after the initial serological diagnosis, to patients with mild and severe COVID-19 and COVID-19-negative controls. Levels of neurofilament light chain and glial fibrillary astrocytic protein, i.e. markers of neuronal damage and reactive astrogliosis, were lower in blood from patients with persistent Post-COVID-19 headache compared to patients with severe COVID-19. Hence, our pilot serological study indicates that long-term Post-COVID-19 headache may not be a sign of underlying neuronal damage or neuroinflammation.