tetano
Editor, Senior Moderator
J Med Virol
. 2021 Mar 16.
doi: 10.1002/jmv.26943. Online ahead of print.
What can cerebrospinal fluid testing and brain autopsies tell us about viral neuroinvasion of SARS-CoV-2
Li Yan-Chao[SUP] 1 2 [/SUP], Zhang Yan[SUP] 3 2 [/SUP], Tan Bai-Hong[SUP] 1 2 [/SUP]
Affiliations
Abstract
To provide instructive clues for clinical practice and further research of SARS-CoV-2 infection, we analyzed the existing literature on viral neuroinvasion of SARS-CoV-2 in COVID-19 patients. To date, SARS-CoV-2 has been detected in the cerebrospinal fluid (CSF) or brain parenchyma in quite a few patients, which provide undeniable evidence for the neuroinvasive potential of this novel coronavirus. In contrast with the cerebrum and cerebellum, the detection rate of SARS-CoV-2 was higher in the olfactory system and the brainstem, both of which also showed severe microgliosis and lymphocytic infiltrations. As compared with the number of patients who underwent viral testing in the central nervous system (CNS), the number of patients showing positive results seems very small. However, it seems too early to conclude that the neuroinvasion of SARS-CoV-2 is rare in COVID-19 patients, because the detection methods and/or sampling procedures in some studies may not be suitable or sufficient to reveal the CNS infection induced by neurotropic viruses. Moreover, the primary symptoms and/or causes of death were distinctly different among examined patients, which probably caused more conspicuous pathological changes than those due to the direct infection that usually localized to specific brain areas. Unfortunately, most autopsy studies did not provide sufficient details about neurological symptoms or suspected diagnoses of the examined patients, and documentation of neuropathological changes was often incomplete. Given the complex pathophysiology of COVID-19 and the characteristics of neurotropic viruses, it is understandable that any study of the CNS infection may inevitably have limitations. This article is protected by copyright. All rights reserved.
Keywords: SARS-CoV-2; autopsy; brain; neuroinvasion; cerebrospinal fluid.
. 2021 Mar 16.
doi: 10.1002/jmv.26943. Online ahead of print.
What can cerebrospinal fluid testing and brain autopsies tell us about viral neuroinvasion of SARS-CoV-2
Li Yan-Chao[SUP] 1 2 [/SUP], Zhang Yan[SUP] 3 2 [/SUP], Tan Bai-Hong[SUP] 1 2 [/SUP]
Affiliations
- PMID: 33724490
- DOI: 10.1002/jmv.26943
Abstract
To provide instructive clues for clinical practice and further research of SARS-CoV-2 infection, we analyzed the existing literature on viral neuroinvasion of SARS-CoV-2 in COVID-19 patients. To date, SARS-CoV-2 has been detected in the cerebrospinal fluid (CSF) or brain parenchyma in quite a few patients, which provide undeniable evidence for the neuroinvasive potential of this novel coronavirus. In contrast with the cerebrum and cerebellum, the detection rate of SARS-CoV-2 was higher in the olfactory system and the brainstem, both of which also showed severe microgliosis and lymphocytic infiltrations. As compared with the number of patients who underwent viral testing in the central nervous system (CNS), the number of patients showing positive results seems very small. However, it seems too early to conclude that the neuroinvasion of SARS-CoV-2 is rare in COVID-19 patients, because the detection methods and/or sampling procedures in some studies may not be suitable or sufficient to reveal the CNS infection induced by neurotropic viruses. Moreover, the primary symptoms and/or causes of death were distinctly different among examined patients, which probably caused more conspicuous pathological changes than those due to the direct infection that usually localized to specific brain areas. Unfortunately, most autopsy studies did not provide sufficient details about neurological symptoms or suspected diagnoses of the examined patients, and documentation of neuropathological changes was often incomplete. Given the complex pathophysiology of COVID-19 and the characteristics of neurotropic viruses, it is understandable that any study of the CNS infection may inevitably have limitations. This article is protected by copyright. All rights reserved.
Keywords: SARS-CoV-2; autopsy; brain; neuroinvasion; cerebrospinal fluid.