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Clinical Neuropathology ; 40(4):S110, 2021.
Article in English | EMBASE | ID: covidwho-1325931


Introduction: SARS-CoV-2 is a novel strain of Coronavirus that mainly targets the respiratory tract, but with important implications also for the CNS. Data deriving from autopsy studies supports the neuroinvasive potential of SARS-CoV-2, even though infection appears to be limited to sparse cells within the brainstem and was not associated with the severity of neuropathological changes. Objectives: In the following study, we assess the neuropathological changes of 14 patients who died following a diagnosis of Sars-CoV-2 infection in Padova, Italy from March 2020 to January 2021. Methods: The cerebrum, cerebellum, brainstem, cranial nerves and meninges were sampled and histopathological evaluation was performed by histochemistry and immunohistochemistry for GFAP, CD8, CD61, CD68 and HLA-DR antibodies. SARS-CoV-2 proteins and RNA were investigated through immunohistochemistry, RTPCR and in-situ hybridization. Results: Small vessel thromboses were identified in two patients, while fresh territory ischaemic lesions were identified in three patients. Astrogliosis and microglial activation were more pronounced at the level of the brainstem in all subjects. SARS-CoV-2 proteins were found within the brainstem and meninges of 4 patients. In one patient, SARS-CoV-2 proteins and RNA were identified throughout the whole rostrocaudal extent of the brainstem and basal ganglia, with prominent involvement of neurons and oligodendrocytes in the mesencephalon, rostral pons and medulla. Conclusion: Although limited by the number of our cohort, the study contributes to define the neuroinvasive potential of SARS-CoV-2 within the CNS. In line with available literature, SARS-CoV-2 invasion does not appear to correlate with the severity of neuropathological changes.