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Autopsies reveal startling new information

Autopsies reveal startling new information

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Analysis of autopsied 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 8 months.

Analysis of tissue samples from the autopsy of 44 people 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

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 isolation of virus in cell culture from multiple non-respiratory tissues, including the brain, which are notable differences compared to other studies.

Possible Implications for ‘Long COVID’

Senior study author Daniel Chertow, MD, MPH, said at the NIH news release that before the work, “the thinking in the field was that SARS-CoV-2 was primarily a respiratory virus.”

Detecting viral presence throughout the body — and sharing those findings with colleagues a year ago — helped scientists investigate the link between widely infected body tissues and “long COVID,” or symptoms that persist for weeks and months after infection.

“We hope to replicate the data on the persistence of the virus and explore the relationship with long-term COVID.”

Study co-author Steven Hewitt, MD, PhD

Part of the NIH-funded Paxlovid RECOVER study, which is expected to begin in 2023, includes expanding the autopsy work highlighted in Nature study, according to co-author Stephen Hewitt, MD, PhD, who serves on a steering committee for the Project RECOVER. The autopsies in the RECOVER study included people who had been vaccinated and infected with worrisome variants—data not available in yesterday’s study.

“We hope to replicate the data on the persistence of the virus and explore the relationship with long-term COVID,” Hewitt said. “In less than a year, we have about 85 cases and we’re working to expand that effort.”

Reference: “SARS-CoV-2 Infection and Persistence in the Human Body and Brain at Autopsy” by Sidney R. Stein, Sabrina K. Ramelli, Alison Grazioli, Jun-Yong Chung, Manmeet Singh, Claude Que 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, Isabella 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, Emmy de Wit, Kevin M. Vanella, Steven M. Hewitt, David E. Kleiner and Daniel S. Chertow, December 14, Nature.
DOI: 10.1038/s41586-022-05542-y




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