Clinical Validation of Serum Neurofilament Light as a Biomarker of Traumatic Axonal Injury

血清神经丝光作为创伤性轴突损伤生物标志物的临床验证

基本信息

批准号：
10239757
负责人：
Ramon Diaz-Arrastia
金额：
$ 27.65万
依托单位：
UNIVERSITY OF PENNSYLVANIA
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-11-15 至 2021-10-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10239757
关键词：
2019-nCoV Acute Acute Brain Injuries Address Admission activity Age Anxiety Area Behavioral Biological Assay Biological Markers Blood Circulation Brain Injuries Brain hemorrhage COVID-19 Clinical Cognitive Cognitive deficits Coronavirus Critical Care Critical Illness Data Delirium Disease Encephalopathies Epidemic Gender Goals Healthcare Hospital Mortality Hospitalization Hospitals Hypoxemia Impaired cognition Impairment Incidence Individual Infection Injury Intensive Care Intracranial Sinus Thrombosis Ischemic Stroke Length of Stay Light Measurement Measures Memory Memory impairment Mental Depression Mental Health Mood Disorders Moods Multiple Organ Failure Nervous System Trauma Nervous system structure Neurocognitive Neurologic Neurologic Effect Neurological outcome Neuronal Injury Neurons Neuropsychology Outcome Outcome Assessment Patients Pennsylvania Phase Plasma Post-Traumatic Stress Disorders Proteins Recovery Rehabilitation therapy Resources Respiratory Failure Risk SARS-CoV-2 infection Serum Structure Survivors Symptoms Syndrome Traumatic Brain Injury Universities Validation Work axon injury cohort contagion disability experience follow up assessment follow-up functional outcomes hemodynamics high risk kidney dysfunction mortality network dysfunction neurofilament neurological recovery novel coronavirus parent grant psychologic psychological outcomes tool venous sinus

项目摘要

ABSTRACT In those who require hospitalization due to infection with the novel coronavirus SARS-CoV-2, a syndrome termed COVID-19, 20% develop critical illness requiring ICU admission.1 COVID-19 critical illness is characterized by multiorgan failure, including acute severe hypoxemic respiratory failure, renal dysfunction, and hemodynamic compromise. Early studies indicate that >30% of hospitalized patients have neurological complications. Critical illness itself is associated with prolonged neurological and psychological impairments that extend far beyond the initial insult, even without obvious brain injury during the acute hospitalization. These disabilities include memory and cognitive dysfunction, depression, and post-traumatic stress disorder. These symptoms are prevalent in survivors of ICU admissions and can be persistent, with at least one or more symptom present in 20-50% of survivors a year or more after hospital discharge. There is reason to be concerned that patients who survive COVID-19 may be at even higher risk, given the prolonged hospital course that is common and the isolation required to contain the contagion. In this study, we aim to analyze neurofilment light (NfL), a biomarker of acute brain injury in patients who are critically ill with COVID-19. We will correlate the expression of NfL with data on neurological compromise in the acute hospitalization as well as long-term cognitive and psychological outcomes. The ultimate goal of this work is to determine if NfL can be used early in the hospital stay to identify patients at highest risk of long-term neurological and psychological compromise. This will help guide management as patients transition from the critical care setting to rehabilitation and recovery.

抽象的对于因感染新型冠状病毒 SARS-CoV-2 而需要住院治疗的患者，称为 COVID-19 的综合征，20% 发展为危重疾病，需要入住 ICU。1 COVID-19 危重疾病的特点是多器官衰竭，包括急性严重低氧血症性呼吸道疾病衰竭、肾功能障碍和血流动力学损害。早期研究表明 >30% 住院患者有神经系统并发症。危重疾病本身与长期的神经和心理损伤远远超出了最初的侮辱，即使在急性住院期间没有明显的脑损伤。这些残疾包括记忆和认知功能障碍、抑郁症和创伤后应激障碍。这些症状在 ICU 住院幸存者中普遍存在，并且可能持续存在，至少有一种症状出院一年或更长时间后，20-50% 的幸存者出现或以上症状。那里有理由担心，COVID-19 幸存者可能面临更高的风险，因为长时间的住院治疗是很常见的，并且需要隔离来控制传染。在这项研究中，我们的目标是分析神经丝光 (NfL)，这是急性脑损伤的生物标志物。患有 COVID-19 的危重患者。我们将 NfL 的表达与数据相关联急性住院期间的神经系统损害以及长期的认知和心理结果。这项工作的最终目标是确定 NfL 是否可以尽早使用在住院期间识别长期神经和心理风险最高的患者妥协。这将有助于指导患者从重症监护环境过渡时的管理到康复和康复。