The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus attacks multiple organs of coronavirus disease 2019 (COVID-19) patients, including the brain. There are worldwide descriptions of neurological deficits in COVID-19 patients. Central nervous system (CNS) symptoms can be present early in the course of the disease. As many as 55% of hospitalized COVID-19 patients have been reported to have neurological disturbances three months after infection by SARS-CoV-2. The mutability of the SARS-COV-2 virus and its potential to directly affect the CNS highlight the urgency of developing technology to diagnose, manage, and treat brain injury in COVID-19 patients. The pathobiology of CNS infection by SARS-CoV-2 and the associated neurological sequelae of this infection remain poorly understood. In this review, we outline the rationale for the use of blood biomarkers (BBs) for diagnosis of brain injury in COVID-19 patients, the research needed to incorporate their use into clinical practice, and the improvements in patient management and outcomes that can result. BBs of brain injury could potentially provide tools for detection of brain injury in COVID-19 patients. Elevations of BBs have been reported in cerebrospinal fluid (CSF) and blood of COVID-19 patients. BB proteins have been analyzed in CSF to detect CNS involvement in patients with infectious diseases, including human immunodeficiency virus and tuberculous meningitis. BBs are approved by the U.S. Food and Drug Administration for diagnosis of mild versus moderate traumatic brain injury and have identified brain injury after stroke, cardiac arrest, hypoxia, and epilepsy. BBs, integrated with other diagnostic tools, could enhance understanding of viral mechanisms of brain injury, predict severity of neurological deficits, guide triage of patients and assignment to appropriate medical pathways, and assess efficacy of therapeutic interventions in COVID-19 patients.

中文翻译：

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用于检测 COVID-19 患者脑损伤的血液生物标志物

严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 病毒会攻击 2019 年冠状病毒病 (COVID-19) 患者的多个器官，包括大脑。全球范围内都有关于 COVID-19 患者神经功能缺陷的描述。中枢神经系统（CNS）症状可能在病程早期就出现。据报道，多达 55% 的住院 COVID-19 患者在感染 SARS-CoV-2 三个月后出现神经系统紊乱。SARS-COV-2 病毒的变异性及其直接影响中枢神经系统的潜力凸显了开发诊断、管理和治疗 COVID-19 患者脑损伤的技术的紧迫性。SARS-CoV-2 感染中枢神经系统的病理学以及该感染的相关神经系统后遗症仍知之甚少。在这篇综述中，我们概述了使用血液生物标志物 (BB) 诊断 COVID-19 患者脑损伤的基本原理、将其使用纳入临床实践所需的研究，以及患者管理和结果的改进。脑损伤的 BB 可能为检测 COVID-19 患者的脑损伤提供工具。据报道，COVID-19 患者的脑脊液 (CSF) 和血液中 BB 升高。已对脑脊液中的 BB 蛋白进行分析，以检测感染性疾病（包括人类免疫缺陷病毒和结核性脑膜炎）患者中枢神经系统的受累情况。BB 经美国食品和药物管理局批准用于诊断轻度与中度创伤性脑损伤，并已识别出中风、心脏骤停、缺氧和癫痫后的脑损伤。BB 与其他诊断工具相结合，可以增强对脑损伤病毒机制的理解，预测神经功能缺损的严重程度，指导患者分流并分配到适当的医疗途径，并评估 COVID-19 患者治疗干预的效果。