Neuropathology of COVID-19

The COVID-19 pandemic has placed global health care systems under unprecedented strain but has, at the same time, provided a unique opportunity for pathologists to turn autopsy findings into directly actionable insights into patient care. The current data on the neuropathology of COVID-19 remains pr...

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Bibliographic Details
Published in:Indian journal of pathology & microbiology 2022-05, Vol.65 (5), p.146-152
Main Authors: Lin, Li-Chun, Hollis, Bailey, Hefti, Marco
Format: Article
Language:English
Subjects:
Aged
Autopsies
Autopsy
Brain
Brain - pathology
Care and treatment
Central nervous system
Coronaviruses
COVID-19
Global health
Health aspects
Health care
Health risks
Humans
Illnesses
Infections
Inflammation
Long COVID
Medical research
Medicine, Experimental
Nervous system
Neurodegeneration
Neurodegenerative diseases
Neurodegenerative Diseases - pathology
neurologic manifestation
Neuropathology
Neurophysiology
Pandemics
Patients
Peripheral nervous system
Public health
Risk
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2
Viral diseases
World health
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Description
Summary:The COVID-19 pandemic has placed global health care systems under unprecedented strain but has, at the same time, provided a unique opportunity for pathologists to turn autopsy findings into directly actionable insights into patient care. The current data on the neuropathology of COVID-19 remains preliminary and is limited by the lack of suitable controls, but certain tentative conclusions can be drawn. SARS-CoV-2 can infect multiple cell types in the central nervous system and does so in a subset of patients, although the clinical significance of direct infections remains in the central nervous system (CNS) and the peripheral nervous system (PNS) infections remains unclear. The best-described neuropathological manifestations of COVID-19 in the brain are variable patterns of neuroinflammation and vascular injury, although again, it remains unclear to what degree these findings are specifically due to COVID-19. There is also intriguing preliminary data to suggest a complex relationship between COVID-19 and neurodegeneration, with certain alleles that increase AD risk also increasing the risk of severe COVID-19, and conversely, the possibility that COVID-19 may increase the risk of neurodegenerative disease. The neuropathology of so-called "long-COVID" and the potential effects of COVID-19, or critical illness in general, on neurodegenerative disease remains unclear. There is thus an urgent need for long-term cohort studies of COVID-19 survivors, including brain donation, particularly in elderly patients, with careful recruitment of controls with similar non-COVID inflammatory illnesses.
ISSN:0377-4929
0974-5130
DOI:10.4103/ijpm.ijpm_1103_21