Neurotropism of SARS-CoV-2: A Pathological Examination of Neurosurgical Specimens.

Autor:	Fujii T; Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles , California , USA., Rennert RC; Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles , California , USA., Hurth KM; Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles , California , USA., Ward PM; Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles , California , USA., Campan M; Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles , California , USA., Mathew AJ; Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles , California , USA., Dubeau L; Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles , California , USA., Wallace WD; Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles , California , USA., Liu CY; Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles , California , USA., Russin JJ; Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles , California , USA.
Jazyk:	angličtina
Zdroj:	Neurosurgery [Neurosurgery] 2024 Feb 01; Vol. 94 (2), pp. 379-388. Date of Electronic Publication: 2023 Sep 20.
DOI:	10.1227/neu.0000000000002684
Abstrakt:	Background and Objectives: Neurological manifestations may occur in more than 80% of patients hospitalized with COVID-19 infection, including severe disruptions of the central nervous system (CNS), such as strokes, encephalitis, or seizures. Although the primary pathophysiological mechanism for the effects of COVID-19 in CNS remains unknown, evidence exists for both direct injury from neuroinvasion and indirect effects from disruptions in systemic inflammatory and coagulation pathways. In this study, we analyzed CNS tissue from living patients to better understand these processes. Methods: With institutional review board approval and patient consent, samples that would be otherwise discarded from patients with active or recent (within 6 days of surgery) COVID-19 infection undergoing neurosurgical intervention were collected and tested for the presence of SARS-CoV-2 using immunohistochemistry, in situ hybridization, electron microscopy, and reverse transcription polymerase chain reaction. Results: Five patients with perioperative mild-to-moderate COVID-19 infection met inclusion criteria (2 male, 3 female; mean age 38.8 ± 13.5 years). Neurosurgical diagnoses included a glioblastoma, a ruptured arteriovenous malformation, a ruptured posterior inferior cerebellar artery aneurysm, a middle cerebral artery occlusion, and a hemorrhagic pontine cavernous malformation. Samples analyzed included the frontal lobe cortex, olfactory nerve, arteriovenous malformation/temporal lobe parenchyma, middle cerebral artery, cerebellum, and cavernous malformation/brainstem parenchyma. Testing for the presence of SARS-CoV-2 was negative in all samples. Conclusion: The CNS is likely not a significant viral reservoir during mild-to-moderate COVID-19 infection, although direct neuroinvasion is not definitively excluded. Additional testing to help elucidate the relative contributions of direct and indirect pathways for CNS injury from COVID is warranted. (Copyright © Congress of Neurological Surgeons 2023. All rights reserved.)
Databáze:	MEDLINE
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