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Journal of Neurology

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28-11-2023 | COVID-19 | Review

Systematic review and evidence gap mapping of biomarkers associated with neurological manifestations in patients with COVID-19

Authors: K. Z. A. Domingues, A. F. Cobre, R. E. L. Lazo, L. S. Amaral, L. M. Ferreira, F. S. Tonin, R. Pontarolo

Published in: Journal of Neurology | Issue 1/2024

Abstract

Objective

This study aimed to synthesize the existing evidence on biomarkers related to coronavirus disease 2019 (COVID-19) patients who presented neurological events.

Methods

A systematic review of observational studies (any design) following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and the Cochrane Collaboration recommendations was performed (PROSPERO: CRD42021266995). Searches were conducted in PubMed and Scopus (updated April 2023). The methodological quality of nonrandomized studies was assessed using the Newcastle‒Ottawa Scale (NOS). An evidence gap map was built considering the reported biomarkers and NOS results.

Results

Nine specific markers of glial activation and neuronal injury were mapped from 35 studies published between 2020 and 2023. A total of 2,237 adult patients were evaluated in the included studies, especially during the acute phase of COVID-19. Neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) biomarkers were the most frequently assessed (n = 27 studies, 77%, and n = 14 studies, 40%, respectively). Although these biomarkers were found to be correlated with disease severity and worse outcomes in the acute phase in several studies (p < 0.05), they were not necessarily associated with neurological events. Overall, 12 studies (34%) were judged as having low methodological quality, 9 (26%) had moderate quality, and 9 (26%) had high quality.

Conclusions

Different neurological biomarkers in neurosymptomatic COVID-19 patients were identified in observational studies. Although the evidence is still scarce and conflicting for some biomarkers, well-designed longitudinal studies should further explore the pathophysiological role of NfL, GFAP, and tau protein and their potential use for COVID-19 diagnosis and management.

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Title: Systematic review and evidence gap mapping of biomarkers associated with neurological manifestations in patients with COVID-19
Authors: K. Z. A. Domingues
A. F. Cobre
R. E. L. Lazo
L. S. Amaral
L. M. Ferreira
F. S. Tonin
R. Pontarolo
Publication date: 28-11-2023
Publisher: Springer Berlin Heidelberg
Keywords: COVID-19
Biomarkers
SARS-CoV-2
Encephalopathy
Published in: Journal of Neurology / Issue 1/2024
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-023-12090-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Systematic review and evidence gap mapping of biomarkers associated with neurological manifestations in patients with COVID-19

Abstract

Objective

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

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