In accordance with the results obtained in the muscle biopsy and blood cohorts, these findings highlighted the prognostic nature of COL19A1 levels in ALS patients that exhibited both COL19A1 levels above average and ALSFRS-r slope at sampling scores ≥ 1 points/month in the serial blood cohort, suggesting that COL19A1 levels could be of valuable support in clinical practice when ALSFRS-r slope at sampling was also considered to monitor the ALS patients’ group. This evidence concerns the gene COL19A1 and amyotrophic lateral sclerosis.