Author: Kantonen, Jonas; Mahzabin, Shamita; Mäyränpää, Mikko I.; Tynninen, Olli; Paetau, Anders; Andersson, Noora; Sajantila, Antti; Vapalahti, Olli; Carpén, Olli; Kekäläinen, Eliisa; Kantele, Anu; Myllykangas, Liisa
Title: Neuropathologic features of four autopsied COVIDâ€19 patients Cord-id: t46giw1h Document date: 2020_8_6
ID: t46giw1h
Snippet: Published descriptions of the neuropathological features of COVIDâ€19 patients have been controversial, ranging from only modest or no pathology to severe hypoxic and hemorrhagic phenotypes, thrombotic complications, acute disseminated encephalomyelitisâ€like changes, and encephalitis and meningitis. Here we describe the neuropathological findings of four COVIDâ€19â€positive patients autopsied at the Helsinki University Hospital during the spring of 2020. While three of the patients (age ran
Document: Published descriptions of the neuropathological features of COVIDâ€19 patients have been controversial, ranging from only modest or no pathology to severe hypoxic and hemorrhagic phenotypes, thrombotic complications, acute disseminated encephalomyelitisâ€like changes, and encephalitis and meningitis. Here we describe the neuropathological findings of four COVIDâ€19â€positive patients autopsied at the Helsinki University Hospital during the spring of 2020. While three of the patients (age range 63–90) exhibited merely mild to moderate hypoxiaâ€associated changes, one 38â€yearâ€old subject with obesity, diabetes (type 2), Parkinson’s disease, and a very severe clinical course was found to have severe ischemic injury, abundant microhemorrhages and enlarged perivascular spaces most pronounced in the white matter and deep gray matter. The pattern of ischemic changes suggested a defect in microcirculation. In addition, a few small perivascular white matter lesions, with macrophages engulfing myelin, were found. No signs of encephalitis or meningitis were detected in any of the patients. When conducting RTâ€PCR and immunohistochemical analyses of brain tissue we could not demonstrate in any of the patients marked injury or presence of SARSâ€CoV2 in the olfactory epithelium, olfactory bulbs, or brain areas responsible for respiratory control. In conclusion, our small autopsy series demonstrates various hypoxiaâ€associated neuropathological features in COVIDâ€19 patients, but no evidence of neurotropism or meningitis/encephalitis.
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