SynthesisJournal of neurology2023
Prognostic performance of blood neurofilament light chain protein in hospitalized COVID-19 patients without major central nervous system manifestations: an individual participant data meta-analysis.
Synthesis in Journal of neurology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 26 citations in OpenAlex.
- Diagnostic and prognostic value of blood neurofilament light chain in ischemic stroke: an individual patient data meta-analysis.Journal of neurology · 2026Pooled it
- Systematic review and evidence gap mapping of biomarkers associated with neurological manifestations in patients with COVID-19.Journal of neurology · 2024Pooled it
- Progranulin AAV gene therapy for frontotemporal dementia: translational studies and phase 1/2 trial interim results.Nature medicine · 2024Trial
- Cognitive and Neuropsychiatric Sequelae After SARS-CoV-2 Infection: A Narrative Review and Exploratory Cross-Sectional Study of Neurofilament Light Chain and GFAP.Brain sciences · 2026Article
- CSF Beta-Synuclein, SNAP-25, and Neurogranin in Infectious and Autoimmune Inflammatory Neurologic Diseases.Neurology(R) neuroimmunology & neuroinflammation · 2025Article
- Elucidating SARS-CoV-2 neurotropism: a comprehensive Mendelian randomization study on cerebrospinal fluid biomarkers and their relevance to COVID-19 neurological manifestations.Virology journal · 2025Article
- Blood neurofilament light chain and S100B as biomarkers of neurological involvement and functional prognosis in COVID-19: a multicenter study.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Observational
- Neurofilaments as biomarkers in neurological disorders - towards clinical application.Nature reviews. Neurology · 2024Review
- Cognitive decline in post-COVID-19 syndrome does not correspond with persisting neuronal or astrocytic damage.Scientific reports · 2024Article
- Serum neurofilament light chain: a predictive marker for outcomes following mild-to-moderate ischemic stroke.Frontiers in neurology · 2024Article
- Central nervous system immune-related disorders after SARS-CoV-2 vaccination: a multicenter study.Frontiers in immunology · 2024Article
- Neurological involvement among non-hospitalized adolescents and young adults 6 months after acute COVID-19.Frontiers in neurology · 2024Article
- Value contribution of blood-based neurofilament light chain as a biomarker in multiple sclerosis using multi-criteria decision analysis.Frontiers in public health · 2024Article
- Clinical characteristics and genetic analysis of children with Omicron BF.7.14 type novel coronavirus-related acute necrotizing encephalopathy.Frontiers in neurology · 2024Article
- NfL concentration in CSF is a quantitative marker of the rate of neurodegeneration in aging and Huntington's disease: a semi-mechanistic model-based analysis.Frontiers in neuroscience · 2024Article
- Cerebrospinal fluid neurofilament light chain levels in children with acquired demyelinating syndrome.Frontiers in pediatrics · 2024Article
- Serum NfL and EGFR/NfL ratio mRNAs as biomarkers for phenotype and disease severity of myelin oligodendrocyte glycoprotein IgG-associated disease.Frontiers in immunology · 2024Article
- Clinical and immunological features in patients with neuroimmune complications of COVID-19 during Omicron wave in China: a case series.Frontiers in immunology · 2024Article
- Prevalence and prognostic value of neurological affections in hospitalized patients with moderate to severe COVID-19 based on objective assessments.Scientific reports · 2023Article
- Editorial: CSF and blood biomarkers in COVID-19 and other neuroinfectious diseases.Frontiers in neurology · 2023Article
Corrections and comments
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Authors and funding
38 authors at 19 institutions in 8 countries.
Funding
Abstract
BACKGROUND AND
aimsTo investigate the prognostic value of blood neurofilament light chain protein (NfL) levels in the acute phase of coronavirus disease 2019 (COVID-19).
methodsWe conducted an individual participant data (IPD) meta-analysis after screening on MEDLINE and Scopus to May 23rd 2022. We included studies with hospitalized adult COVID-19 patients without major COVID-19-associated central nervous system (CNS) manifestations and with a measurement of blood NfL in the acute phase as well as data regarding at least one clinical outcome including intensive care unit (ICU) admission, need of mechanical ventilation (MV) and death. We derived the age-adjusted measures NfL Z scores and conducted mixed-effects modelling to test associations between NfL Z scores and other variables, encompassing clinical outcomes. Summary receiver operating characteristic curves (SROCs) were used to calculate the area under the curve (AUC) for blood NfL.
resultsWe identified 382 records, of which 7 studies were included with a total of 669 hospitalized COVID-19 cases (mean age 66.2 ± 15.0 years, 68.1% males). Median NfL Z score at admission was elevated compared to the age-corrected reference population (2.37, IQR: 1.13-3.06, referring to 99th percentile in healthy controls). NfL Z scores were significantly associated with disease duration and severity. Higher NfL Z scores were associated with a higher likelihood of ICU admission, need of MV, and death. SROCs revealed AUCs of 0.74, 0.80 and 0.71 for mortality, need of MV and ICU admission, respectively.
conclusionsBlood NfL levels were elevated in the acute phase of COVID-19 patients without major CNS manifestations and associated with clinical severity and poor outcome. The marker might ameliorate the performance of prognostic multivariable algorithms in COVID-19.
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Registered trials
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