Biomarkers for CNS injury in CSF are elevated in COVID-19 and associated with neurological symptoms and disease severity

BACKGROUND: Neurological symptoms have been frequently reported in hospitalized patients with coronavirus disease 2019 (COVID-19) and biomarkers of CNS injury are reported to be increased in plasma but not extensively studied in CSF. This study examines CSF for biomarkers of CNS injury and other pathology in relation to neurological symptoms and disease severity in patients with neurological manifestations of COVID-19. METHODS: Nineteen patients with neurological symptoms and mild to critical COVID-19 were prospectively included. Extensive analysis of CSF, including measurement of biomarkers of CNS injury (neurofilament light chain protein (NfL) glial fibrillary acidic protein (GFAp) and total tau) was performed and related to neurological features and disease severity. RESULTS: Neurological symptoms included altered mental status (42%), headache (42%), central (21%) and peripheral weakness (32%). Two patients demonstrated minor pleocytosis and four patients had increased immunoglobulin G levels in CSF. Neuronal autoantibody testing using commercial tests was negative in all patients. Increased CSF levels of NfL, GFAp and total-tau protein were seen in 63%, 37%, and 16% of patients, respectively. Increased NfL correlated with disease severity, time in intensive care and level of consciousness. NfL in CSF was higher in patients with central neurological symptoms. CONCLUSION: Although limited by small sample size, our data suggest that levels of NfL, GFAp and total tau in CSF are commonly elevated in patients with COVID-19 with neurological symptoms. This is in contrast to the standard CSF work-up where pathological findings are scarce. NfL in particular, is associated with central neurological symptoms and disease severity

The extent of neuroradiological findings in COVID-19 shows correlation with blood biomarkers, Glasgow coma scale score and days in intensive care

Background and purpose: A wide range of neuroradiological findings has been reported in patients with coronavirus disease 2019 (COVID-19), ranging from subcortical white matter changes to infarcts, haemorrhages and focal contrast media enhancement. These have been descriptively but inconsistently reported and correlations with clinical findings and biomarkers have been difficult to extract from the literature. The purpose of this study was to quantify the extents of neuroradiological findings in a cohort of patients with COVID-19 and neurological symptoms, and to investigate correlations with clinical findings, duration of intensive care and biomarkers in blood. Material and methods: Patients with positive SARS-CoV-2 and at least one new-onset neurological symptom were included from April until July 2020. Nineteen patients were examined regarding clinical symptoms, biomarkers in blood and MRI of the brain. In order to quantify the MRI findings, a semi-quantitative neuroradiological severity scale was constructed a priori, and applied to the MR images by two specialists in neuroradiology. Results and conclusions: The score from the severity scale correlated significantly with blood biomarkers of CNS injury (glial fibrillary acidic protein, total-tau, ubiquitin carboxyl-terminal hydrolase L1) and inflammation (C-reactive protein), Glasgow Coma Scale score, and the number of days spent in intensive care. The underlying radiological assessments had inter-rater agreements of 90.5%/86% (for assessments with 2/3 alternatives). Total intraclass correlation was 0.80. Previously reported neuroradiological findings in COVID-19 have been diverse and heterogenous. In this study, the extent of findings in MRI examination of the brain, quantified using a structured report, shows correlation with relevant biomarkers

Structure determination of the (1×2) and (1×3) reconstructions of Pt(110) by low-energy electron diffraction

The atomic geometry of the (1×2) and (1×3) structures of the Pt(100) surface has been determined from a low-energy electron-diffraction intensity analysis. Both structures are found to be of the missing-row type, consisting of (111) microfacets, and with similar relaxations in the subsurface layers. In both reconstructions the top-layer spacing is contracted by approximately 20% together with a buckling of about 0.17 Å in the third layer and a small lateral shift of about 0.04 Å in the second layer. Further relaxations down to the fourth layer were detectable. The surface relaxations correspond to a variation of interatomic distances, ranging from -7% to +4%, where in general a contraction of approximately 3% for the distances parallel to the surface occurs. The Pendry and Zanazzi-Jona R factors were used in the analysis, resulting in a minimum value of RP=0.36 and RZJ=0.26 for 12 beams at normal incidence for the (1×2) structure, and similar agreement for 19 beams of the (1×3) structure. The (1×3) structure has been reproducibly obtained after heating the crystal in an oxygen atmosphere of 5×10-6 mbar at 1200 K for about 30 min and could be removed by annealing at 1800 K for 45 min after which the (1×2) structure appeared again. Both reconstructed surfaces are clean within the detection limits of the Auger spectrometer. CO adsorption lifts the reconstruction in both structures. After desorption at 500 K the initial structures appear again, indicating that at least one of the reconstructions does not represent the equilibrium structure of the clean surface and may be stabilized by impurities