During the 6 months after ALS diagnosis, several blood biomarkers exhibited a significant association with the risk of death (or the use of invasive ventilation), including total cholesterol (HR: 0.62, 95%CI 0.41–0.94), low-density lipoprotein (LDL-C, HR: 0.57, 95%CI 0.38–0.87), apolipoprotein B (HR: 0.64, 95%CI 0.43–0.96), mean corpuscular volume (MCV, HR: 1.53, 95%CI 1.07–2.19), and carbon dioxide (CO2, HR: 1.42, 95%CI 1.08–1.87), in addition to NfL in CSF (HR: 2.61, 95%CI 1.47–4.65) (Fig. 1A). This evidence concerns the gene NEFL and amyotrophic lateral sclerosis.