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Vol. 24, Art. 86 (pp. 1258-1274)    |    2023       

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Morphological and molecular biological study of the brain in patients with ii and iii waves of covid-19 and in the post-covid period

Mitrofanova L.B., Vorobeva O.M., Sterkhova K.A., Makarov I.A., Rasulov Z.M., Pal`tsev A.A., Vas`kova N.L., Gulyaev D.A.

Almazov National Medical Research Centre

Brief summary

There are a growing number of reports in the current literature that neurological disorders are not only manifest during COVID-19, but also persist in patients in the post-acute period. The aim: to determine the presence of SARS-CoV-2 in the brain structures of patients who died from acute COVID-19 and had a coronavirus infection. Materials and methods. The materials were fragments of the cerebral cortex, trunk and hippocampus of 57 patients who died from COVID-19 in the II and III waves of the disease; gliomas and arteriovenous malformation in 10 patients (surgical material) and the cortex of the frontal lobes in 3 patients (autopsy material) who had a coronavirus infection; cortex of the frontal lobes of 5 patients who died in 2018 (control group). Immunohistochemical analysis was performed with antibodies to SARS-CoV-2 spike protein, ACE2, CD26, RT-PCR for SARS-CoV-2 RNA - in the brain of 10 patients of the second wave of COVID-19 and the surgical material of 10 patients with Long COVID. Results. SARS-CoV-2 expression was detected in neurons of the cerebral cortex, brainstem and hippocampus in 100% of patients with wave II, 70% with wave III COVID-19 and 77% with Long COVID. At the same time, no differences were found in the number of neurons with the expression of this antigen in any of the groups. The average number of neurons expressing ACE2 and CD26 in wave II was 83 and 8%, and in wave III, 75 and 20%, respectively. No correlation was found between the number of neurons expressing SARS-CoV-2, CD26, and ACE2. RT-PCR reveals subthreshold SARS-CoV-2 RNA values in 23% of patients with gliomas. Conclusion. Immunohistochemical study revealed the expression of SARS-CoV-2 spike protein in neurons of the cerebral cortex, brainstem and hippocampus of patients with acute COVID-19, as well as in neurons and tumor cells of gliomas of patients with Long COVID. At the same time, RT-PCR detected viral RNA only at subthreshold values in 23% of patients with tumors, which may indicate unproductive persistence of the virus in the central nervous system and does not exclude its role in oncogenesis and tumor progression.


Key words

SARS-CoV-2, ACE2, DPP4, immunohistochemistry and brain polymerase chain reaction, Long COVID

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