Brainstem neuropathology in two cases of COVID-19: SARS-CoV-2 trafficking between brain and lung.
J Neurol
; 268(12): 4486-4491, 2021 Dec.
Article
in English
| MEDLINE | ID: covidwho-1231904
ABSTRACT
INTRODUCTION:
SARS-CoV-2 might spread through the nervous system, reaching respiratory centers in the brainstem. Because we recently reported neurophysiological brainstem reflex abnormalities in COVID-19 patients, we here neuropathologically assessed structural brainstem damage in two COVID-19 patients. MATERIALS ANDMETHODS:
We assessed neuropathological features in two patients who died of COVID-19 and in two COVID-19 negative patients as controls. Neuronal damage and corpora amylacea (CA) numbers /mm2 were histopathologically assessed. Other features studied were the immunohistochemical expression of the SARS-CoV-2 nucleoprotein (NP) and the Iba-1 antigen for glial activation.RESULTS:
Autopsies showed normal gross brainstem anatomy. Histopathological examination demonstrated increased neuronal and CA damage in Covid-19 patients' medulla oblongata. Immunohistochemistry disclosed SARS-CoV-2 NP in brainstem neurons and glial cells, and in cranial nerves. Glial elements also exhibited a widespread increase in Iba-1 expression. Sars-Co-V2 was immunohistochemically detected in the vagus nerve fibers.DISCUSSION:
Neuropathologic evidence showing SARS-CoV-2 in the brainstem and medullary damage in the area of respiratory centers strongly suggests that the pathophysiology of COVID-19-related respiratory failure includes a neurogenic component. Sars-Co-V2 detection in the vagus nerve, argues for viral trafficking between brainstem and lung.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Brain Stem
/
COVID-19
/
Lung
/
Nervous System Diseases
Type of study:
Case report
/
Observational study
Limits:
Humans
Language:
English
Journal:
J Neurol
Year:
2021
Document Type:
Article
Affiliation country:
S00415-021-10604-8
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