Brain ischemic injury in COVID-19-infected patients: a series of 10 post-mortem cases.
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ABSTRACT:
SUBMITTER: Fabbri VP
PROVIDER: S-EPMC7536900 | biostudies-literature | 2021 Jan
REPOSITORIES: biostudies-literature
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Brain ischemic injury in COVID-19-infected patients: a series of 10 post-mortem cases.
Fabbri Viscardo P VP Foschini Maria P MP Lazzarotto Tiziana T Gabrielli Liliana L Cenacchi Giovanna G Gallo Carmine C Aspide Raffaele R Frascaroli Guido G Cortelli Pietro P Riefolo Mattia M Giannini Caterina C D'Errico Antonietta A
Brain pathology (Zurich, Switzerland) 20201102 1
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Project description:Recently, a new respiratory infectious disease called COVID-19 has emerged and created a global emergency. It was initially linked to the animal-to-human transmission. However, it is now thought that COVID-19 is spreading through human-to-human transmission mainly via droplets. As there is no definite antiviral therapy for the treatment of cases with COVID-19 the best option for slowing down the pandemic and reducing mortality rates is protection against the virus of interest. To achieve this goal obtaining information about how first cases infected with COVID-19 is crucial. Hence, this study aims to review the studies published in peer-reviewed journals to report the first confirmed cases with COVID-19. Herein, we review the origin, symptoms, diagnostic tests, and progress of the disease and possible actions of authorities which would be effective in similar pandemics in the future. This study reviewed 13 cases (5 females and 8 males; 25-61 years old) from 10 countries. All cases have recovered from COVID-19. The results of this review suggested that timely reports of the confirmed cases, notifying World Health Organization and providing information to the general population about the methods of spreading the virus would have decreased the number of infected cases and mortality rates. In addition, the travel history of the first confirmed cases in various countries suggested that prompt actions in restricting travels and closing borders could be an efficient strategy in preventing the transmission of the disease outside of the affected sites. Efforts should be taken by health authorities for preparing the world for future epidemic/pandemic in terms of developing advanced screening strategies in the borders and diagnostic strategies for early identification of infected cases.
| S-EPMC7492837 | biostudies-literature
Project description:BackgroundProminent clinical symptoms of COVID-19 include CNS manifestations. However, it is unclear whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19, gains access to the CNS and whether it causes neuropathological changes. We investigated the brain tissue of patients who died from COVID-19 for glial responses, inflammatory changes, and the presence of SARS-CoV-2 in the CNS.MethodsIn this post-mortem case series, we investigated the neuropathological features in the brains of patients who died between March 13 and April 24, 2020, in Hamburg, Germany. Inclusion criteria comprised a positive test for SARS-CoV-2 by quantitative RT-PCR (qRT-PCR) and availability of adequate samples. We did a neuropathological workup including histological staining and immunohistochemical staining for activated astrocytes, activated microglia, and cytotoxic T lymphocytes in the olfactory bulb, basal ganglia, brainstem, and cerebellum. Additionally, we investigated the presence and localisation of SARS-CoV-2 by qRT-PCR and by immunohistochemistry in selected patients and brain regions.Findings43 patients were included in our study. Patients died in hospitals, nursing homes, or at home, and were aged between 51 years and 94 years (median 76 years [IQR 70-86]). We detected fresh territorial ischaemic lesions in six (14%) patients. 37 (86%) patients had astrogliosis in all assessed regions. Activation of microglia and infiltration by cytotoxic T lymphocytes was most pronounced in the brainstem and cerebellum, and meningeal cytotoxic T lymphocyte infiltration was seen in 34 (79%) patients. SARS-CoV-2 could be detected in the brains of 21 (53%) of 40 examined patients, with SARS-CoV-2 viral proteins found in cranial nerves originating from the lower brainstem and in isolated cells of the brainstem. The presence of SARS-CoV-2 in the CNS was not associated with the severity of neuropathological changes.InterpretationIn general, neuropathological changes in patients with COVID-19 seem to be mild, with pronounced neuroinflammatory changes in the brainstem being the most common finding. There was no evidence for CNS damage directly caused by SARS-CoV-2. The generalisability of these findings needs to be validated in future studies as the number of cases and availability of clinical data were low and no age-matched and sex-matched controls were included.FundingGerman Research Foundation, Federal State of Hamburg, EU (eRARE), German Center for Infection Research (DZIF).
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Project description:We review the microbiological aspects of COVID-19 infection and present the microbiological studies that should be performed in forensic cases. We describe the taxonomic characteristics of the virus, its relationship with the coronaviridae family and its genetic structure. We briefly present the clinical and pathological characteristics of COVID-19 infection, as well as the co-infections that could be associated with this virus. In the laboratory, PCR is a first-choice technique in the acute phase of the infection, together with antigen and serological studies. Finally, we describe the main objectives of microbiological studies in the deceased in relation to the COVID-19 pandemic, as well as the main post-mortem microbiological analysis to be carried out in the medico-legal context. The microbiological analysis should aim to detect both SARS-CoV-2 and coinfections, which may also contribute to the cause of death.
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2023-10-22 | GSE160147 | GEO
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