An analysis of autopsied tissue samples from 44 people who died with COVID-19 found that the SAR-CoV-2 virus spread throughout the body, including the brain, and persisted for almost 8 months.
An analysis of tissue samples from autopsies of 44 people who died with
” data-gt-translate-attributes=”[{” 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
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] and [in situ hybridization]as well as isolating the virus in cell culture from several non-respiratory tissues, including the brain, which are notable differences from other studies.
Possible ramifications for the “long COVID”
The study’s lead author, Daniel Chertow, MD, MPH, said in an NIH press release that prior to the work, “the thinking in the field was that SARS-CoV-2 was primarily a respiratory virus. “.
The discovery of viral presence throughout the body – and sharing these findings with colleagues a year ago – has helped scientists explore a relationship between widely infected body tissues and “long COVID”, or the symptoms that persist for weeks and months after infection.
“We hope to replicate data on viral persistence and investigate the relationship to long COVID.”
— Study co-author Stephen Hewitt, MD, PhD
Part of an NIH-funded Paxlovid RECOVER trial expected to begin in 2023 includes an extension of the autopsy work highlighted in the Nature study, according to co-author Stephen Hewitt, MD, PhD, who serves on the steering committee of the RECOVER project. Autopsies from the RECOVER trial include people both vaccinated and infected with worrying variants, data that was not available in yesterday’s study.
“We hope to replicate viral persistence data and investigate the relationship to long COVID,” Hewitt said. “In less than a year, we have about 85 cases, and we are working to expand those efforts.”
Reference: “Infection and persistence of SARS-CoV-2 in the human body and brain at autopsy” by 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, and Daniel S. Chertow, December 14, 2022, Nature.
DOI: 10.1038/s41586-022-05542-y
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