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Analysis of autopsy tissue samples from 44 people who died from COVID-19 showed that the SARS-CoV-2 virus spread throughout the body, including into the brain, and lingered for nearly 8 months
.
The study was published Dec.
14 in the journal Nature
.
Scientists at the National Institutes of Health (NIH) tested autopsy samples
conducted between April 2020 and March 2021.
They took extensive samples of the nervous systems of 11 of the patients, including the brains
.
All patients died of COVID-19 and no one was vaccinated
.
Thirty-eight samples tested positive for the new coronavirus, 3 were negative, and 3 were plasma-free
.
Thirty percent of patients were female, with a median age of 62.
5 years
.
Twenty-seven patients (61.
4%) had three or more comorbidities
.
The median time interval from morbidity to mortality was 18.
5 days
.
The analysis showed that SARS-CoV-2 primarily infected and destroyed airways and lung tissue
, as expected.
But the researchers also found viral RNA in 84 different body parts and body fluids, and in one case, they isolated viral RNA
230 days after the onset of symptoms.
The researchers detected RNA and proteins
for SARS-CoV-2 in the hypothalamus and cerebellum of one patient, as well as in the spinal cord and basal ganglia of two other patients.
But they found little damage to brain tissue, "despite having a large viral load
.
" ”
"We demonstrated that in the first two weeks after symptom onset, the virus replicates
in multiple non-respiratory sites.
"
The researchers also isolated live SARS-CoV-2 virus from different tissues inside and outside the respiratory tract, including the brain, heart, lymph nodes, gastrointestinal tract, adrenal glands, and eyes
.
They isolated the virus (45%)
from 55 samples.
"Our focus on shorter postmortem intervals, a comprehensive standardized tissue collection method that dissects the brain prior to fixation and subsequently stores the tissue in RNA, and flash freezing of fresh tissue allows us to detect and quantify SARS-CoV-2 RNA levels with high sensitivity by [polymerase chain reaction] and [in situ hybridization], as well as isolate virus from cell culture from multiple non-respiratory tissues, including the brain, which is a significant difference compared to other studies.
"
。 ”
Daniel L.
Herr, MD, MS, senior study author, said in a press release from the National Institutes of Health that prior to this work, "the idea in the field was that SARS-CoV-2 was primarily a respiratory virus
.
" ”
Finding the virus throughout the body and sharing the findings with colleagues a year ago helped scientists explore the relationship
between widely infected body tissues and "long COVID" (long crowns)—symptoms that last weeks or months after infection).
The NIH-funded Paxlovid RECOVER trial, which is expected to begin in 2023, includes an extension of the autopsy work highlighted in the Nature study, according to co-author Stephen Hewitt, M.
D.
, who is a member of
the RECOVER Project Steering Committee.
The autopsy in the RECOVER trial included vaccinated and infected people with the variant, data that were not available
in yesterday's study.
"We want to replicate data on the persistence of the virus and study the relationship
with the 'long crown,' Hewitt said.
In less than a year, we have about 85 cases, and we're working to scale up those efforts
.
”
Reference: SARS-CoV-2 infection and persistence in the human body and brain at autopsy.
Sydney R.
Stein, Sabrina C.
Ramelli, Alison Grazioli, Joon-Yong Chung, Manmeet Singh, Claude Kwe Yinda, Clayton W.
Winkler, Junfeng Sun, James M.
Dickey, Kris Ylaya, Sung Hee Ko, Andrew P.
Platt, Peter D.
Burbelo, Martha Quezado, Stefania Pittaluga, Madeleine Purcell, Vincent J.
Munster, Frida Belinky, Marcos J.
Ramos-Benitez, Eli A.
Boritz, Izabella A.
Lach, Daniel L.
Herr, Joseph Rabin, Kapil K.
Saharia, Ronson J.
Madathil, Ali Tabatabai, Shahabuddin Soherwardi, Michael T.
McCurdy, NIH COVID-19 Autopsy Consortium, Karin E.
Peterson, Jeffrey I.
Cohen, Emmie de Wit, Kevin M.
Vannella, Stephen M.
Hewitt, David E.
Kleiner & Daniel S.
Chertow, 14 December 2022, Nature.
