PMID- 33875374 OWN - NLM STAT- MEDLINE DCOM- 20210623 LR - 20210623 IS - 1872-8952 (Electronic) IS - 1388-2457 (Print) IS - 1388-2457 (Linking) VI - 132 IP - 7 DP - 2021 Jul TI - Critical illness polyneuropathy, myopathy and neuronal biomarkers in COVID-19 patients: A prospective study. PG - 1733-1740 LID - S1388-2457(21)00489-2 [pii] LID - 10.1016/j.clinph.2021.03.016 [doi] AB - OBJECTIVE: The aim was to characterize the electrophysiological features and plasma biomarkers of critical illness polyneuropathy (CIN) and myopathy (CIM) in coronavirus disease 2019 (COVID-19) patients with intensive care unit acquired weakness (ICUAW). METHODS: An observational ICU cohort study including adult patients admitted to the ICU at Uppsala University Hospital, Uppsala, Sweden, from March 13th to June 8th 2020. We compared the clinical, electrophysiological and plasma biomarker data between COVID-19 patients who developed CIN/CIM and those who did not. Electrophysiological characteristics were also compared between COVID-19 and non-COVID-19 ICU patients. RESULTS: 111 COVID-19 patients were included, 11 of whom developed CIN/CIM. Patients with CIN/CIM had more severe illness; longer ICU stay, more thromboembolic events and were more frequently treated with invasive ventilation for longer than 2 weeks. In particular CIN was more frequent among COVID-19 patients with ICUAW (50%) compared with a non-COVID-19 cohort (0%, p = 0.008). Neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAp) levels were higher in the CIN/CIM group compared with those that did not develop CIN/CIM (both p = 0.001) and correlated with nerve amplitudes. CONCLUSIONS: CIN/CIM was more prevalent among COVID-19 ICU patients with severe illness. SIGNIFICANCE: COVID-19 patients who later developed CIN/CIM had significantly higher NfL and GFAp in the early phase of ICU care, suggesting their potential as predictive biomarkers for CIN/CIM. CI - Copyright (c) 2021 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved. FAU - Frithiof, Robert AU - Frithiof R AD - Department of Surgical Sciences, Anesthesiology and Intensive Care Medicine, Uppsala University, Uppsala, Sweden. FAU - Rostami, Elham AU - Rostami E AD - Department of Neuroscience, Neurosurgery, Uppsala University, Uppsala, Sweden; Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden. FAU - Kumlien, Eva AU - Kumlien E AD - Department of Neuroscience, Neurology, Uppsala University, Uppsala, Sweden. FAU - Virhammar, Johan AU - Virhammar J AD - Department of Neuroscience, Neurology, Uppsala University, Uppsala, Sweden. FAU - Fallmar, David AU - Fallmar D AD - Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden. FAU - Hultstrom, Michael AU - Hultstrom M AD - Department of Surgical Sciences, Anesthesiology and Intensive Care Medicine, Uppsala University, Uppsala, Sweden; Department of Medical Cell Biology, Integrative Physiology, Uppsala University, Uppsala, Sweden. FAU - Lipcsey, Miklos AU - Lipcsey M AD - Department of Surgical Sciences, Anesthesiology and Intensive Care Medicine, Uppsala University, Uppsala, Sweden. FAU - Ashton, Nicholas AU - Ashton N AD - Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Molndal, Sweden; Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden; King's College London, Institute of Psychiatry, Psychology & Neuroscience, Maurice Wohl Clinical Neuroscience Institute, London, UK; NIHR Biomedical Research Centre for Mental Health & Biomedical Research Unit for Dementia at South London & Maudsley NHS Foundation, London, UK. FAU - Blennow, Kaj AU - Blennow K AD - Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Molndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Molndal, Sweden. FAU - Zetterberg, Henrik AU - Zetterberg H AD - Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Molndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Molndal, Sweden; Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK; UK Dementia Research Institute at UCL, London, UK. FAU - Punga, Anna Rostedt AU - Punga AR AD - Department of Neuroscience, Clinical Neurophysiology, Uppsala University, Uppsala, Sweden. Electronic address: anna.rostedt.punga@neuro.uu.se. LA - eng PT - Journal Article PT - Observational Study DEP - 20210401 PL - Netherlands TA - Clin Neurophysiol JT - Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology JID - 100883319 RN - 0 (Biomarkers) SB - IM CIN - Clin Neurophysiol. 2021 Jul;132(7):1716-1717. PMID: 33934968 MH - Aged MH - Biomarkers/blood MH - COVID-19/*complications/physiopathology MH - Critical Illness MH - Female MH - Humans MH - Intensive Care Units MH - Length of Stay/statistics & numerical data MH - Male MH - Middle Aged MH - Muscle Weakness/etiology MH - Muscular Diseases/blood/*etiology/physiopathology MH - Polyneuropathies/blood/*etiology/physiopathology MH - Prospective Studies MH - Respiration, Artificial/statistics & numerical data MH - Thromboembolism/etiology PMC - PMC8012169 OTO - NOTNLM OT - COVID-19 OT - Critical illness neuropathy OT - Myopathy OT - NFL OT - SARS-CoV-2 COIS- Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: KB has served as a consultant, at advisory boards, or at data monitoring committees for Abcam, Axon, Biogen, Julius Clinical, Lilly, MagQu, Novartis, Roche Diagnostics, and Siemens Healthineers, and is a co-founder of Brain Biomarker Solutions in Gothenburg AB (BBS), which is a part of the GU Ventures Incubator Program (outside submitted work). HZ has served at scientific advisory boards for Denali, Roche Diagnostics, Wave, Samumed, Siemens Healthineers, Pinteon Therapeutics and CogRx, has given lectures in symposia sponsored by Fujirebio, Alzecure and Biogen, and is a co-founder of Brain Biomarker Solutions in Gothenburg AB (BBS), which is a part of the GU Ventures Incubator Program (all outside submitted work). The other authors report no disclosures. EDAT- 2021/04/21 06:00 MHDA- 2021/06/24 06:00 PMCR- 2021/04/01 CRDT- 2021/04/20 05:50 PHST- 2020/12/14 00:00 [received] PHST- 2021/03/14 00:00 [revised] PHST- 2021/03/15 00:00 [accepted] PHST- 2021/04/21 06:00 [pubmed] PHST- 2021/06/24 06:00 [medline] PHST- 2021/04/20 05:50 [entrez] PHST- 2021/04/01 00:00 [pmc-release] AID - S1388-2457(21)00489-2 [pii] AID - 10.1016/j.clinph.2021.03.016 [doi] PST - ppublish SO - Clin Neurophysiol. 2021 Jul;132(7):1733-1740. doi: 10.1016/j.clinph.2021.03.016. Epub 2021 Apr 1.