An analysis of autopsy tissue samples from 44 people who died of COVID-19 revealed that the SAR-CoV-2 virus had spread throughout the body, including the brain, and persisted for nearly eight months.
Analysis of tissue samples from autopsies of 44 people who died in[{” attribute=””>COVID-19 shows that SAR-CoV-2 virus spread throughout the body—including into the brain—and that it lingered for almost 8 months. The study was published on December 14 in the journal Nature.
Scientists from the National Institutes of Health (NIH) tested samples from autopsies that were performed from April 2020 to March 2021. They conducted extensive sampling of the nervous system, including the brain, in 11 of the patients.
RNA and viable virus in various organs
All of the patients died with COVID-19, and none were vaccinated. The blood plasma of 38 patients tested positive for SARS-CoV-2, 3 tested negative, and plasma was unavailable for the other 3.
Thirty percent of the patients were female, and the median age was 62.5 years. Twenty-seven patients (61.4%) had three or more comorbidities. The median interval from symptom onset to death was 18.5 days.
Analysis showed that SARS-CoV-2, as expected, primarily infected and damaged airway and lung tissue. But the researchers also found viral RNA in 84 distinct body locations and bodily fluids, and in one case they isolated viral RNA 230 days after a patient’s symptoms began.
The researchers detected SARS-CoV-2 RNA and protein in the hypothalamus and cerebellum of one patient and in the spinal cord and basal ganglia of two other patients. But they found little damage to brain tissue, “despite substantial viral burden.”
“We demonstrated virus replication in multiple non-respiratory sites during the first two weeks following symptom onset.”
The investigators also isolated viable SARS-CoV-2 virus from diverse tissues in and outside the respiratory tract, including the brain, heart, lymph nodes, gastrointestinal tract, adrenal gland, and eye. They isolated virus from 25 of 55 specimens tested (45%).
The authors wrote, “We demonstrated virus replication in multiple non-respiratory sites during the first two weeks following symptom onset.”
They add, “Our focus on short postmortem intervals, a comprehensive standardized approach to tissue collection, dissecting the brain before fixation, preserving tissue in RNA later, and flash freezing of fresh tissue allowed us to detect and quantify SARS-CoV-2 RNA levels with high sensitivity by [polymerase chain reaction] When [in situ hybridization], isolating viruses in cell culture from multiple non-respiratory tissues, including brain, is a notable difference compared to other studies. “
Potential impact of ‘long COVID’
Senior study author Daniel Chertow, MD, MPH told the NIH: news release Prior to that work, “the thinking in the field was that SARS-CoV-2 is primarily a respiratory virus.”
Discovering the presence of the virus throughout the body and sharing that finding with colleagues a year ago led scientists to believe that widespread infected body tissue and the “long COVID”, i.e. weeks to months after infection, We were able to investigate the relationship with subsequent symptoms.
“We hope to replicate data on viral persistence and study long-term relationships with COVID.”
— Study co-author Stephen Hewitt, MD, PhD
Part of the NIH-funded Paxlovid RECOVER trial, scheduled to begin in 2023, includes: Nature According to co-author Stephen Hewitt, M.D., RECOVER projectAutopsies for the RECOVER trial included people who were vaccinated and infected with the subspecies of concern. This is data that was not available in yesterday’s study.
“We want to replicate data on virus persistence and study its relationship to COVID over time,” said Hewitt. “We have had about 85 cases in less than a year and are working to scale up these 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 By 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.
DOI: 10.1038/s41586-022-05542-y
