Neuropathological analysis of the brains of fifty-two patients with COVID-19

Teresa Wierzba-Bobrowicz; Paweł Krajewski; Sylwia Tarka; Albert Acewicz; Paulina Felczak; Tomasz Stępień; Maciej P. Golan; Michał Grzegorczyk

doi:10.5114/fn.2021.108829

eISSN: 1509-572x
ISSN: 1641-4640

Folia Neuropathologica

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3/2021
vol. 59

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abstract:

Original paper

Neuropathological analysis of the brains of fifty-two patients with COVID-19

Teresa Wierzba-Bobrowicz

¹

,

Paweł Krajewski

²

,

Sylwia Tarka

²

,

Albert Acewicz

¹

,

Paulina Felczak

¹

,

Tomasz Stępień

¹

,

Maciej P. Golan

³

,

Michał Grzegorczyk

⁴

Department of Neuropathology, Institute of Psychiatry and Neurology, Warsaw, Poland
Department of Forensic Medicine, Medical University of Warsaw, Warsaw, Poland
Laboratory of Molecular Oncology and Innovative Therapies, Military Institute of Medicine, Warsaw, Poland
Department of Anatomy, Medical University of Warsaw, Warsaw, Poland

Folia Neuropathol 2021; 59 (3): 219-231

DOI: https://doi.org/10.5114/fn.2021.108829

Online publish date: 2021/10/05

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Coronavirus disease 2019 (COVID-19) poses a global challenge to healthcare and society in the early 21st century. We report neuropathological changes in 52 patients aged between 22 years and 88 years (median 58 years) who were infected with the CoV-2 coronavirus. Patients died under various circumstances and had various pre-existing diseases. The inclusion criteria for this study were: positive result for the nasopharyngeal swab for SARS-CoV-2 RNA, diagnosis of pneumonia of SARS-CoV-2 or nucleoproteins of SARS-CoV-2 in pulmonary tissue confirmed by immunohistochemical methods (IHC). Samples from all brain structures and lung specimens were taken for histopathological examinations. Brain and pulmonary samples were stained typically with histological and immunohistochemical methods and small tissue fragments were examined with the transmission electron microscope (TEM). The light and electron microscopy examination confirmed the numerous neuropathological changes in the brains of the patients infected with the CoV-2. Many of these changes were caused by pre-existing diseases of patients and/or by necessary treatment. However, vascular lesions and the inflammatory process seem to be characteristic of the CoV-2 infection. In all of the structures of 52 brains of patients, damage of the vessel walls and morphological feature of the damage to the blood-brain barrier were observed. Lymphocytic and microglial infiltrates, both perivascular and diffuse, were also observed. Hence, the brain changes due to COVID-19 infection, could be called COVID-19 cerebral angiopathy with diffuse inflammation.

keywords:

Neuropathological analysis of the brains of fifty-two patients with COVID-19

Teresa Wierzba-Bobrowicz 1 , Paweł Krajewski 2 , Sylwia Tarka 2 , Albert Acewicz 1 , Paulina Felczak 1 , Tomasz Stępień 1 , Maciej P. Golan 3 , Michał Grzegorczyk 4

COVID-19, CoV-2, SARS-CoV-2, neuropathology, ultrastructure

Teresa Wierzba-Bobrowicz

¹

,

Paweł Krajewski

²

,

Sylwia Tarka

²

,

Albert Acewicz

¹

,

Paulina Felczak

¹

,

Tomasz Stępień

¹

,

Maciej P. Golan

³

,

Michał Grzegorczyk

⁴