Autopsies Reveal Startling New Information

An evaluation of tissue samples from autopsies of 44 individuals who died with[{” 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] and [in situ hybridization]in addition to isolating the virus in cell tradition from a number of non-respiratory tissues, together with the mind, that are notable variations from different research.

Attainable ramifications for the “lengthy COVID”

The research’s lead writer, Daniel Chertow, MD, MPH, mentioned in an NIH press launch that previous to the work, “the pondering within the discipline was that SARS-CoV-2 was primarily a respiratory virus. “.

The invention of viral presence all through the physique – and sharing these findings with colleagues a 12 months in the past – has helped scientists discover a relationship between extensively contaminated physique tissues and “lengthy COVID”, or the signs that persist for weeks and months after an infection.

“We hope to copy knowledge on viral persistence and examine the connection to lengthy COVID.”

— Examine co-author Stephen Hewitt, MD, PhD

A part of an NIH-funded Paxlovid RECOVER trial anticipated to start in 2023 consists of an extension of the post-mortem work highlighted within the Nature research, in response to co-author Stephen Hewitt, MD, PhD, who serves on the steering committee of the RECOVER undertaking. Autopsies from the RECOVER trial embody folks each vaccinated and contaminated with worrying variants, knowledge that was not out there in yesterday’s research.

“We hope to copy viral persistence knowledge and examine the connection to lengthy COVID,” Hewitt mentioned. “In lower than a 12 months, we’ve about 85 instances, and we’re working to increase these efforts.”

Reference: “SARS-CoV-2 an infection and persistence within the human physique and mind at post-mortem” by Sydney R. Stein, Sabrina C. Ramelli, Alison Grazioli, Joon-Yong Chung, Manmeet Singh, Claude Kwe Yinda, Clayton W. Winkler, Junfeng Solar, 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, Isabella A. Lach, Daniel L. Herr, Joseph Rabin, Kapil Ok. Saharia, Ronson J. Madathil, Ali Tabatabai, Shahabuddin Soherwardi, Michael T. McCurdy, NIH COVID-19 Post-mortem Consortium, Karin E. Peterson, Jeffrey I. Cohen, Emmie de Witt, Kevin M. Vannella, Stephen M. Hewitt, David E. Kleiner, and Daniel S. Chertow, December 14 Nature.
DOI: 10.1038/s41586-022-05542-y