SARS-Cov-2 infection and neuropathological findings: a report of 18 cases and review of the literature

Acta Neuropathologica Communications

Research

Amandine Collin¹  Egor Zindy¹  Justine Allard¹  Christine Decaestecker²  Nicolas Gaspard³  Olivier De Witte⁴  Sarah De Clercq⁵  Ricardo De Mendonça⁵  Laetitia Lebrun⁵  Stefan Rusu⁵  Lara Absil⁵  Nicky D’Haene⁵  Marie-Lucie Racu⁵  Andrea Alex Schiavo⁵  Myriam Remmelink⁵  Isabelle Salmon⁶  Maria-Beatriz Lopes⁷ 

[1]DIAPath, Center for Microscopy and Molecular Imaging (CMMI), ULB, Gosselies, Belgium

[2]DIAPath, Center for Microscopy and Molecular Imaging (CMMI), ULB, Gosselies, Belgium

[3]Laboratory of Image Synthesis and Analysis, Brussels School of Engineering/École Polytechnique de Brussels, ULB, Brussels, Belgium

[4]Department of Neurology, Université Libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (HUB), CUB Hôpital Erasme, Erasme University Hospital, Brussels, Belgium

[5]Department of Neurosurgery, Université Libre de Bruxelles (ULB)Hôpital Universitaire de Bruxelles (HUB), CUB Hôpital ErasmeErasme University Hospital, Brussels, Belgium

[6]Department of Pathology, Erasme University Hospital, Université Libre de Bruxelles (ULB)Hôpital Universitaire de Bruxelles (HUB), CUB Hôpital Erasme, 808 Route de Lennik, B-1070, Brussels, Belgium

[7]Department of Pathology, Erasme University Hospital, Université Libre de Bruxelles (ULB)Hôpital Universitaire de Bruxelles (HUB), CUB Hôpital Erasme, 808 Route de Lennik, B-1070, Brussels, Belgium

[8]DIAPath, Center for Microscopy and Molecular Imaging (CMMI), ULB, Gosselies, Belgium

[9]Department of Pathology, University of Virginia Health System, Charlottesville, VA, USA

关键词: SARS-CoV-2;    COVID-19;    PCR;    Postmortem procedure;    Immunohistochemistry;   

DOI  :  10.1186/s40478-023-01566-1

 received in 2023-02-21, accepted in 2023-04-15,  发布年份 2023

来源: Springer

【 摘 要 】

IntroductionCOVID-19-infected patients harbour neurological symptoms such as stroke and anosmia, leading to the hypothesis that there is direct invasion of the central nervous system (CNS) by SARS-CoV-2. Several studies have reported the neuropathological examination of brain samples from patients who died from COVID-19. However, there is still sparse evidence of virus replication in the human brain, suggesting that neurologic symptoms could be related to mechanisms other than CNS infection by the virus. Our objective was to provide an extensive review of the literature on the neuropathological findings of postmortem brain samples from patients who died from COVID-19 and to report our own experience with 18 postmortem brain samples.Material and methodsWe used microscopic examination, immunohistochemistry (using two different antibodies) and PCR-based techniques to describe the neuropathological findings and the presence of SARS-CoV-2 virus in postmortem brain samples. For comparison, similar techniques (IHC and PCR) were applied to the lung tissue samples for each patient from our cohort. The systematic literature review was conducted from the beginning of the pandemic in 2019 until June 1st, 2022.ResultsIn our cohort, the most common neuropathological findings were perivascular haemosiderin-laden macrophages and hypoxic-ischaemic changes in neurons, which were found in all cases (n = 18). Only one brain tissue sample harboured SARS-CoV-2 viral spike and nucleocapsid protein expression, while all brain cases harboured SARS-CoV-2 RNA positivity by PCR. A colocalization immunohistochemistry study revealed that SARS-CoV-2 antigens could be located in brain perivascular macrophages.The literature review highlighted that the most frequent neuropathological findings were ischaemic and haemorrhagic lesions, including hypoxic/ischaemic alterations. However, few studies have confirmed the presence of SARS-CoV-2 antigens in brain tissue samples.ConclusionThis study highlighted the lack of specific neuropathological alterations in COVID-19-infected patients. There is still no evidence of neurotropism for SARS-CoV-2 in our cohort or in the literature.

【 授权许可】

CC BY   
© The Author(s) 2023

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