Admission Serum Inflammatory and Injury Biomarkers Are Associated with In-Hospital Mortality in Neurological Inpatients with Confirmed SARS-CoV-2 Infection: The Brain-COVID Cohort Study

TL;DR

This study finds that high levels of certain blood markers at hospital admission predict higher risk of death in neurological patients with confirmed SARS-CoV-2 infection.

Contribution

Identifies serum biomarkers (IL-6, LDH, ferritin, hs-troponin I) as early predictors of mortality in neurological inpatients with SARS-CoV-2.

Findings

Non-survivors had significantly higher IL-6, LDH, ferritin, and hs-troponin I levels (all p < 0.001).

LDH, ferritin, IL-6, and hs-troponin I were independently associated with mortality in multivariable analysis.

Elevated biomarkers reflect systemic disease severity, not CNS-specific neuroinflammation.

Abstract

Patients hospitalized with neurological disorders may be at increased risk of adverse outcomes when infected with SARS-CoV-2. We evaluated whether early routine serum inflammatory and injury markers obtained at hospital admission are associated with in-hospital mortality in this subgroup. This single-center observational cohort included 460 consecutive adult inpatients admitted for neurological disorders with SARS-CoV-2 infection confirmed on admission or during hospitalization. Serum IL-6, LDH, ferritin, hs-troponin I, CRP, procalcitonin, and D-dimers measured within 6 h of hospital admission for neurological disorder were analyzed and compared between survivors and non-survivors. Non-survivors had higher IL-6, LDH, ferritin, and hs-troponin I (all p < 0.001). In multivariable analysis, LDH, ferritin, IL-6, and hs-troponin I were independently associated with mortality. We conclude that in neurological inpatients with confirmed SARS-CoV-2 infection, elevated early IL-6, LDH, ferritin, and hs-troponin I are associated with in-hospital mortality. These markers likely reflect systemic disease severity rather than CNS-specific neuroinflammation and may support early risk stratification in this population.

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