Neurofilament light chain and vaccination status associate with clinical outcomes in severe COVID-19
Young Erben,
Mercedes Prudencio,
Christopher P. Marquez,
Karen R. Jansen-West,
Michael G. Heckman,
Launia J. White,
Judith A. Dunmore,
Casey N. Cook,
Meredith T. Lilley,
Neda Qosja,
Yuping Song,
Rana Hanna Al Shaikh,
Lillian M. Daughrity,
Jordan L. Bartfield,
Gregory S. Day,
Björn Oskarsson,
Katharine A. Nicholson,
Zbigniew K. Wszolek,
Jonathan B. Hoyne,
Tania F. Gendron,
James F. Meschia,
Leonard Petrucelli
Affiliations
Young Erben
Division of Vascular and Endovascular Surgery, Mayo Clinic, Jacksonville, FL 32224, USA
Mercedes Prudencio
Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA; Neuroscience Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, FL 32224, USA
Christopher P. Marquez
Department of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, FL 32224, USA
Karen R. Jansen-West
Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA
Michael G. Heckman
Division of Clinical Trials and Biostatistics, Mayo Clinic, Jacksonville, FL 32224, USA
Launia J. White
Division of Clinical Trials and Biostatistics, Mayo Clinic, Jacksonville, FL 32224, USA
Judith A. Dunmore
Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA
Casey N. Cook
Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA; Neuroscience Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, FL 32224, USA
Meredith T. Lilley
Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA
Neda Qosja
Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA
Yuping Song
Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA
Rana Hanna Al Shaikh
Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA; Department of Neurology, Mayo Clinic, Jacksonville, FL 32224, USA
Lillian M. Daughrity
Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA
Jordan L. Bartfield
Department of Neurology, Mayo Clinic, Jacksonville, FL 32224, USA
Gregory S. Day
Department of Neurology, Mayo Clinic, Jacksonville, FL 32224, USA
Björn Oskarsson
Department of Neurology, Mayo Clinic, Jacksonville, FL 32224, USA
Katharine A. Nicholson
Sean M. Healey & AMG Center for ALS, Massachusetts General Hospital (MGH), Boston, MA 02114, USA
Zbigniew K. Wszolek
Department of Neurology, Mayo Clinic, Jacksonville, FL 32224, USA
Jonathan B. Hoyne
Department of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, FL 32224, USA
Tania F. Gendron
Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA; Neuroscience Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, FL 32224, USA
James F. Meschia
Department of Neurology, Mayo Clinic, Jacksonville, FL 32224, USA; Corresponding author
Leonard Petrucelli
Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA; Neuroscience Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, FL 32224, USA; Corresponding author
Summary: Blood neurofilament light chain (NFL) is proposed to serve as an estimate of disease severity in hospitalized patients with coronavirus disease 2019 (COVID-19). We show that NFL concentrations in plasma collected from 880 patients with COVID-19 within 5 days of hospital admission were elevated compared to controls. Higher plasma NFL associated with worse clinical outcomes including the need for mechanical ventilation, intensive care, prolonged hospitalization, and greater functional disability at discharge. No difference in the studied clinical outcomes between black/African American and white patients was found. Finally, vaccination associated with less disability at time of hospital discharge. In aggregate, our findings support the utility of measuring NFL shortly after hospital admission to estimate disease severity and show that race does not influence clinical outcomes caused by COVID-19 assuming equivalent access to care, and that vaccination may lessen the degree of COVID-19-caused disability.
