Neurochemical evidence of astrocytic and neuronal injury commonly found in COVID-19
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- Plasma levels of the neuron damage markers brain-derived tau and glial fibrillary acidic protein in Lyme neuroborreliosis: A longitudinal study, Ticks and Tick-borne Diseases, 16, 3, (102459), (2025).https://doi.org/10.1016/j.ttbdis.2025.102459
- Advances in Understanding Inflammation and Tissue Damage: Markers of Persistent Sequelae in COVID-19 Patients, Journal of Clinical Medicine, 14, 5, (1475), (2025).https://doi.org/10.3390/jcm14051475
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- Neuropsychiatric Burden of SARS-CoV-2: A Review of Its Physiopathology, Underlying Mechanisms, and Management Strategies, Viruses, 16, 12, (1811), (2024).https://doi.org/10.3390/v16121811
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We read with interest the article published by Kanberg et al.,1 who assessed two plasma biomarkers of CNS injury: neurofilament light chain protein (NfL) and glial fibrillary acidic protein (GFAp) in patients with COVID-19. Their results reflect the presence of nervous tissue damage in patients moderately and severely infected by SARS-CoV-2, without clinical evidence of neurologic impairment. This was established by a sequence of early astrocytic response, supported by elevated GFAP levels in moderate and severe COVID patients, and more delayed axonal injury in severe cases, evidenced by increased levels of NfL.
An increasing amount of reports demonstrate that neurotropism is a common feature of SARS-CoV-2, and that acute respiratory failure in COVID-19 could be related to infection of the brainstem.2 Thus, the early prediction of brain damage with a rapidly accessible biomarker could prove useful to detect patients at higher risks of complications.
Blood-based brain derived proteins have proved to biomarkers of brain damage and have been employed to assess degree of brain injury and outcome predictors in different clinical neurological contexts and as predictors of subclinical brain damage in hypertension, aging and other vascular risk conditions.3
Neuroprotection based on human recombinant erythropoietin (EPO),4 and neuroEPO5 as a therapeutic strategy in COVID was recently proposed. Kanberg et al´s results represent a clear-cut signal of underlying brain damage in COVID-19, which support the need for an early intervention to prevent or mitigate neurological damage. Follow-up of these patients could reveal the utility of these biomarkers in COVID-19.
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