Clinical and Laboratory Experiences During the COVID Pandemic: Biomarker Associations with Neurologic and Systemic Symptoms

<p class="p1" style="margin-bottom: 0px; font-stretch: normal; font-size: 12px; line-height: normal; font-family: Helvetica; font-size-adjust: none; font-kerning: auto; font-variant-alternates: normal; font-variant-ligatures: normal; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-position: normal; font-feature-settings: normal; font-optical-sizing: auto; font-variation-settings: normal;">Background: COVID-19 is a multisystem disease that manifests not only respiratory but also neurological <p class="p1" style="margin-bottom: 0px; font-stretch: normal; font-size: 12px; line-height: normal; font-family: Helvetica; font-size-adjust: none; font-kerning: auto; font-variant-alternates: normal; font-variant-ligatures: normal; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-position: normal; font-feature-settings: normal; font-optical-sizing: auto; font-variation-settings: normal;">and systemic symptoms. In this study, we evaluated the clinical and laboratory experiences obtained <p class="p1" style="margin-bottom: 0px; font-stretch: normal; font-size: 12px; line-height: normal; font-family: Helvetica; font-size-adjust: none; font-kerning: auto; font-variant-alternates: normal; font-variant-ligatures: normal; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-position: normal; font-feature-settings: normal; font-optical-sizing: auto; font-variation-settings: normal;">during the pandemic and the relationship between biomarkers and clinical symptoms. <p class="p1" style="margin-bottom: 0px; font-stretch: normal; font-size: 12px; line-height: normal; font-family: Helvetica; font-size-adjust: none; font-kerning: auto; font-variant-alternates: normal; font-variant-ligatures: normal; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-position: normal; font-feature-settings: normal; font-optical-sizing: auto; font-variation-settings: normal;">Method: 423 COVID-19 patients were included in the study. Demographic data, disease history, <p class="p1" style="margin-bottom: 0px; font-stretch: normal; font-size: 12px; line-height: normal; font-family: Helvetica; font-size-adjust: none; font-kerning: auto; font-variant-alternates: normal; font-variant-ligatures: normal; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-position: normal; font-feature-settings: normal; font-optical-sizing: auto; font-variation-settings: normal;">comorbidities and symptoms were recorded. Neurologic symptoms included headache, dizziness, <p class="p1" style="margin-bottom: 0px; font-stretch: normal; font-size: 12px; line-height: normal; font-family: Helvetica; font-size-adjust: none; font-kerning: auto; font-variant-alternates: normal; font-variant-ligatures: normal; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-position: normal; font-feature-settings: normal; font-optical-sizing: auto; font-variation-settings: normal;">distraction, difficulty understanding, difficulty walking and epileptic seizures. Systemic symptoms included <p class="p1" style="margin-bottom: 0px; font-stretch: normal; font-size: 12px; line-height: normal; font-family: Helvetica; font-size-adjust: none; font-kerning: auto; font-variant-alternates: normal; font-variant-ligatures: normal; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-position: normal; font-feature-settings: normal; font-optical-sizing: auto; font-variation-settings: normal;">fatigue, muscle aches and joint pains. Laboratory parameters included CRP, D-dimer, LDH, NSE, GFAP, <p class="p1" style="margin-bottom: 0px; font-stretch: normal; font-size: 12px; line-height: normal; font-family: Helvetica; font-size-adjust: none; font-kerning: auto; font-variant-alternates: normal; font-variant-ligatures: normal; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-position: normal; font-feature-settings: normal; font-optical-sizing: auto; font-variation-settings: normal;">S100B, lymphocyte and neutrophil levels.Results: Significant correlations were found between neurologic symptoms such as headache, distraction <p class="p1" style="margin-bottom: 0px; font-stretch: normal; font-size: 12px; line-height: normal; font-family: Helvetica; font-size-adjust: none; font-kerning: auto; font-variant-alternates: normal; font-variant-ligatures: normal; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-position: normal; font-feature-settings: normal; font-optical-sizing: auto; font-variation-settings: normal;">and comprehension difficulties and CRP (p&lt;0.001), D-dimer (p&lt;0.001) and LDH (p=0.042) levels. NSE <p class="p1" style="margin-bottom: 0px; font-stretch: normal; font-size: 12px; line-height: normal; font-family: Helvetica; font-size-adjust: none; font-kerning: auto; font-variant-alternates: normal; font-variant-ligatures: normal; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-position: normal; font-feature-settings: normal; font-optical-sizing: auto; font-variation-settings: normal;">and GFAP levels were significantly lower in patients with comprehension difficulties (p=0.023, p=0.035). <p class="p1" style="margin-bottom: 0px; font-stretch: normal; font-size: 12px; line-height: normal; font-family: Helvetica; font-size-adjust: none; font-kerning: auto; font-variant-alternates: normal; font-variant-ligatures: normal; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-position: normal; font-feature-settings: normal; font-optical-sizing: auto; font-variation-settings: normal;">Lymphocyte levels were higher in those with distractibility (p=0.009). D-dimer and LDH levels were <p class="p1" style="margin-bottom: 0px; font-stretch: normal; font-size: 12px; line-height: normal; font-family: Helvetica; font-size-adjust: none; font-kerning: auto; font-variant-alternates: normal; font-variant-ligatures: normal; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-position: normal; font-feature-settings: normal; font-optical-sizing: auto; font-variation-settings: normal;">significantly higher in patients with acute cerebrovascular events. <p class="p1" style="margin-bottom: 0px; font-stretch: normal; font-size: 12px; line-height: normal; font-family: Helvetica; font-size-adjust: none; font-kerning: auto; font-variant-alternates: normal; font-variant-ligatures: normal; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-position: normal; font-feature-settings: normal; font-optical-sizing: auto; font-variation-settings: normal;">Conclusion: The neurologic effects of COVID-19 are associated with inflammation, vascular dysfunction <p class="p1" style="margin-bottom: 0px; font-stretch: normal; font-size: 12px; line-height: normal; font-family: Helvetica; font-size-adjust: none; font-kerning: auto; font-variant-alternates: normal; font-variant-ligatures: normal; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-position: normal; font-feature-settings: normal; font-optical-sizing: auto; font-variation-settings: normal;">and neuronal/glial damage. The findings provide important insights into understanding the disease course <p class="p1" style="margin-bottom: 0px; font-stretch: normal; font-size: 12px; line-height: normal; font-family: Helvetica; font-size-adjust: none; font-kerning: auto; font-variant-alternates: normal; font-variant-ligatures: normal; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-position: normal; font-feature-settings: normal; font-optical-sizing: auto; font-variation-settings: normal;">by linking biomarkers with clinical symptoms.