Brainstem neuropathology in two cases of COVID-19 (2021)

pattismith

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Brainstem neuropathology in two cases of COVID-19: SARS-CoV-2 trafficking between brain and lung | SpringerLink

Journal of Neurology volume 268, pages4486–4491 (2021)Cite this article

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 and methods

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
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Pyrrhus

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Thanks for posting this great case report!

Brainstem neuropathology in two cases of COVID-19: SARS-CoV-2 trafficking between brain and lung (Bulfamonte et al., 2021)
https://link.springer.com/article/10.1007/s00415-021-10604-8
Main points:
  • In two patients, damage was seen in the medulla oblongata part of the brainstem.
  • Coronavirus proteins were found in neurons in the brainstem and cranial nerves such as the vagus nerve.
  • The presence of the coronavirus in the vagus nerve and medulla oblongata suggests that the virus might travel inside the vagus nerve from the lung to the brainstem.
From: Neuroinflammation in Long Covid?
https://forums.phoenixrising.me/threads/neuroinflammation-in-long-covid.81396/