J Neuropathol Exp Neurol . Neuropathological findings in COVID-19: an autopsy cohort

[tetano]

J Neuropathol Exp Neurol


. 2022 Nov 10;nlac101.
doi: 10.1093/jnen/nlac101. Online ahead of print.
Neuropathological findings in COVID-19: an autopsy cohort


Kathryn L Eschbacher ¹ , Rachel A Larsen ¹ , Ann M Moyer ¹ , Ramanath Majumdar ¹ , Robert Ross Reichard ¹



Affiliations

• PMID: 36355625
• DOI: 10.1093/jnen/nlac101

Abstract

The literature regarding the neuropathological findings in cases of SARS-CoV-2 infection, which causes coronavirus disease 2019 (COVID-19), is expanding. We identified 72 patients who died of COVID-19 (n = 48) or had recovered shortly before death (n = 24) and had autopsies performed at our institution (49 males, 23 females; median age at death 76.4 years, range: 0.0-95.0 years). Droplet digital polymerase chain reaction (ddPCR) for the detection of SARS-CoV-2 was performed (n = 58) in multiple brain regions. In cases the assay was successfully completed (n = 50), 98.0% were negative (n = 49) and 2% were indeterminate (n = 1). Most histologic findings were typical of the patient age demographic, such as neurodegenerative disease and arteriolosclerosis. A subset of cases demonstrated findings which may be associated with sequelae of critical illness. We identified 3 cases with destructive perivascular lesions with axonal injury, one of which also harbored perivascular demyelinating lesions. These rare cases may represent a parainfectious process versus sequelae of vascular injury. The lack of detectable SARS-CoV-2 by ddPCR or significant histologic evidence of direct infection suggests that active encephalitis is not a feature of COVID-19.

Keywords: Autopsy; COVID-19; Neuropathological findings; SARS-CoV-2.