Observational studyNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2025
Blood neurofilament light chain and S100B as biomarkers of neurological involvement and functional prognosis in COVID-19: a multicenter study.
Observational study in Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- Immune-endothelial-coagulation crosstalk as a driver of multi-organ dysfunction in severe viral pneumonia.Frontiers in immunology · 2026Review
- Differences in concentration of neuron-specific enolase (NSE), neutrophil elastase (NE), and calcium-binding protein S100B in viral diseases: a pilot study focused on normoglycemic COVID-19 patients.Frontiers in molecular biosciences · 2026Article
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22 authors.
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Abstract
BACKGROUND AND
aimCOVID-19 is associated with neurological complications, termed neuro-COVID, affecting patient outcomes. We aimed to evaluate the association between serum neurofilament light chain (NfL) and S100B biomarkers with the presence of neurological manifestations and functional prognosis in COVID-19 patients.
methodsA multicenter prospective cohort study was conducted in three hospitals in the Emilia-Romagna region, Italy, from March 2020 to April 2022. Hospitalized patients with PCR-confirmed COVID-19 were enrolled. Serum S100B and NfL levels were measured in the acute or subacute phase after admission. Diagnostic accuracy was assessed using receiver operating characteristic (ROC) analyses. Statistical analyses were performed to evaluate the association between biomarkers, clinical/laboratory variables, and prognosis, specifically focusing on worsening of the modified Rankin Scale (mRS) from admission to discharge.
resultsA total of 279 patients (153 males, median age 76.7 years) were included. Among them, 69 (24.7%) developed neuro-COVID. Serum NfL levels were significantly higher in the neuro-COVID group (median 110 vs 68.3; p = 0.035) and correlated with severe encephalopathy and extracranial neurologic manifestations. The ROC analysis showed low accuracy in the discrimination between the two groups for both NfL and S100B. Key predictors of worsening mRS included mechanical ventilation (OR = 9.56, 95% CI = 1.67-54.75; p = 0.011), severe encephalopathy (OR = 5.10, 95% CI = 1.58-16.19; p = 0.006), and elevated S100B levels (OR = 2.62, 95% CI = 1.10-6.46; p = 0.037).
conclusionsSerum NfL and S100B biomarkers were not accurate in discriminating neuro-COVID patients, however NfL levels were associated with severe and extracranial neuro-COVID, while S100B with functional outcomes, potentially informing clinical management.
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