Long-Term Persisting SARS-CoV-2 RNA and Pathological Findings: Lessons Learnt From a Series of 35 COVID-19 Autopsies
| Autor: | Maccio, Umberto, Zinkernagel, Annelies S, Schuepbach, Reto, Probst-Mueller, Elsbeth, Frontzek, Karl, Brugger, Silvio D, Hofmaenner, Daniel Andrea, Moch, Holger, Varga, Zsuzsanna |
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| Přispěvatelé: | University of Zurich |
| Rok vydání: | 2021 |
| Předmět: |
Medicine (General)
10208 Institute of Neuropathology COVID-19 610 Medicine & health General Medicine postmortal swabs pulmonary superinfections 10234 Clinic for Infectious Diseases SARS-CoV-2 RNA PCR R5-920 10049 Institute of Pathology and Molecular Pathology histopathology long-COVID 10023 Institute of Intensive Care Medicine |
| Zdroj: | Frontiers in Medicine, Vol 9 (2022) |
| ISSN: | 2296-858X |
| Popis: | BackgroundLong-term sequelae of coronavirus disease 2019 (COVID-19), including the interaction between persisting viral-RNA and specific tissue involvement, pose a challenging issue. In this study, we addressed the chronological correlation (after first clinical diagnosis and postmortem) between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA and organ involvement.MethodsThe presence of postmortem SARS-CoV-2 RNA from 35 complete COVID-19 autopsies was correlated with the time interval between the first diagnosis of COVID-19 and death and with its relationship to morphologic findings.ResultsSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA can be evident up to 40 days after the first diagnosis and can persist to 94 hours after death. Postmortem SARS-CoV-2 RNA was mostly positive in lungs (70%) and trachea (69%), but all investigated organs were positive with variable frequency. Late-stage tissue damage was evident up to 65 days after initial diagnosis in several organs. Positivity for SARS-CoV-2 RNA in pulmonary swabs correlated with diffuse alveolar damage (p = 0.0009). No correlation between positive swabs and other morphologic findings was present. Cerebral (p = 0.0003) and systemic hemorrhages (p = 0.009), cardiac thrombi (p = 0.04), and ischemic events (p = 0.03) were more frequent in the first wave, whereas bacterial pneumonia (p = 0.03) was more prevalent in the second wave. No differences in biometric data, clinical comorbidities, and other autopsy findings were found.ConclusionsOur data provide evidence not only of long-term postmortem persisting SARS-CoV-2 RNA but also of tissue damage several weeks after the first diagnosis of SARS-CoV-2 infection. Additional conditions, such as concomitant bacterial pulmonary superinfection, lung aspergillosis, thromboembolic phenomena, and hemorrhages can further worsen tissue damage. |
| Databáze: | OpenAIRE |
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