Multifactorial white matter damage in the acute phase and pre-existing conditions may drive cognitive dysfunction after SARS-CoV-2 infection: neuropathology-based evidence

Medientyp: E-Artikel

Titel: Multifactorial white matter damage in the acute phase and pre-existing conditions may drive cognitive dysfunction after SARS-CoV-2 infection : neuropathology-based evidence

Beteiligte: Gelpi, Ellen [Verfasser:in]; Klotz, Sigrid [Verfasser:in]; Beyerle, Miriam [Verfasser:in]; Wischnewski, Sven [Verfasser:in]; Harter, Verena [Verfasser:in]; Kirschner, Harald [Verfasser:in]; Stolz, Katharina [Verfasser:in]; Reisinger, Christoph [Verfasser:in]; Lindeck-Pozza, Elisabeth [Verfasser:in]; Zoufaly, Alexander [Verfasser:in]; Leoni, Marlene [Verfasser:in]; Gorkiewicz, Gregor [Verfasser:in]; Zacharias, Martin [Verfasser:in]; Haberler, Christine [Verfasser:in]; Hainfellner, Johannes [Verfasser:in]; Woehrer, Adelheid [Verfasser:in]; Hametner, Simon [Verfasser:in]; Roetzer, Thomas [Verfasser:in]; Voigtländer, Till [Verfasser:in]; Ricken, Gerda [Verfasser:in]; Endmayr, Verena [Verfasser:in]; Haider, Carmen [Verfasser:in]; Ludwig, Judith [Verfasser:in]; Polt, Andrea [Verfasser:in]; Wilk, Gloria [Verfasser:in]; Schmid, Susanne [Verfasser:in]; Erben, Irene [Verfasser:in]; Nguyen, Anita [Verfasser:in]; Lang, Susanna [Verfasser:in]; Simonitsch-Klupp, Ingrid [Verfasser:in]; Kornauth, Christoph [Verfasser:in]; Nackenhorst, Maja [Verfasser:in]; Kläger, Johannes [Verfasser:in]; Kain, Renate [Verfasser:in]; Chott, Andreas [Verfasser:in]; Wasicky, Richard [Verfasser:in]; Krause, Robert [Verfasser:in]; Weiss, Günter [Verfasser:in]; Löffler-Rag, Judith [Verfasser:in]; Berger, Thomas [Verfasser:in]; Moser, Patrizia [Verfasser:in]; Soleiman, Afshin [Verfasser:in]; Asslaber, Martin [Verfasser:in]; Sedivy, Roland [Verfasser:in]; Klupp, Nikolaus [Verfasser:in]; Klimpfinger, Martin [Verfasser:in]; Risser, Daniele [Verfasser:in]; Budka, Herbert [Verfasser:in]; Schirmer, Lucas [Verfasser:in]; Pröbstel, Anne-Katrin [Verfasser:in]; Höftberger, Romana [Verfasser:in]

Erschienen: 31 March 2023

Sprache: Englisch

DOI: 10.3390/v15040908

Identifikator:

Schlagwörter: COVID-19 ; leukoencephalopathy ; neuropathology ; SARS-CoV-2 ; white matter

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Beschreibung: Background: There is an urgent need to better understand the mechanisms underlying acute and long-term neurological symptoms after COVID-19. Neuropathological studies can contribute to a better understanding of some of these mechanisms. Methods: We conducted a detailed postmortem neuropathological analysis of 32 patients who died due to COVID-19 during 2020 and 2021 in Austria. Results: All cases showed diffuse white matter damage with a diffuse microglial activation of a variable severity, including one case of hemorrhagic leukoencephalopathy. Some cases revealed mild inflammatory changes, including olfactory neuritis (25%), nodular brainstem encephalitis (31%), and cranial nerve neuritis (6%), which were similar to those observed in non-COVID-19 severely ill patients. One previously immunosuppressed patient developed acute herpes simplex encephalitis. Acute vascular pathologies (acute infarcts 22%, vascular thrombosis 12%, diffuse hypoxic-ischemic brain damage 40%) and pre-existing small vessel diseases (34%) were frequent findings. Moreover, silent neurodegenerative pathologies in elderly persons were common (AD neuropathologic changes 32%, age-related neuronal and glial tau pathologies 22%, Lewy bodies 9%, argyrophilic grain disease 12.5%, TDP43 pathology 6%). Conclusions: Our results support some previous neuropathological findings of apparently multifactorial and most likely indirect brain damage in the context of SARS-CoV-2 infection rather than virus-specific damage, and they are in line with the recent experimental data on SARS-CoV-2-related diffuse white matter damage, microglial activation, and cytokine release.

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