Postmortem brain 7T MRI with minimally invasive pathological correlation in deceased COVID-19 subjects
Abstract Background Brain abnormalities are a concern in COVID-19, so we used minimally invasive autopsy (MIA) to investigate it, consisting of brain 7T MR and CT images and tissue sampling via transethmoidal route with at least three fragments: the first one for reverse transcription polymerase cha...
| Main Authors: | , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SpringerOpen
2022-01-01
|
| Series: | Insights into Imaging |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13244-021-01144-w |
| _version_ | 1798026163170312192 |
|---|---|
| author | Maria da Graça Morais Martin Vitor Ribeiro Paes Ellison Fernando Cardoso Carlos Eduardo Borges Passos Neto Cristina Takami Kanamura Claudia da Costa Leite Maria Concepcion Garcia Otaduy Renata Aparecida de Almeida Monteiro Thais Mauad Luiz Fernando Ferraz da Silva Luiz Henrique Martins Castro Paulo Hilario Nascimento Saldiva Marisa Dolhnikoff Amaro Nunes Duarte-Neto |
| author_facet | Maria da Graça Morais Martin Vitor Ribeiro Paes Ellison Fernando Cardoso Carlos Eduardo Borges Passos Neto Cristina Takami Kanamura Claudia da Costa Leite Maria Concepcion Garcia Otaduy Renata Aparecida de Almeida Monteiro Thais Mauad Luiz Fernando Ferraz da Silva Luiz Henrique Martins Castro Paulo Hilario Nascimento Saldiva Marisa Dolhnikoff Amaro Nunes Duarte-Neto |
| author_sort | Maria da Graça Morais Martin |
| collection | DOAJ |
| description | Abstract Background Brain abnormalities are a concern in COVID-19, so we used minimally invasive autopsy (MIA) to investigate it, consisting of brain 7T MR and CT images and tissue sampling via transethmoidal route with at least three fragments: the first one for reverse transcription polymerase chain reaction (RT-PCR) analysis and the remaining fixed and stained with hematoxylin and eosin. Two mouse monoclonal anti-coronavirus (SARS-CoV-2) antibodies were employed in immunohistochemical (IHC) reactions. Results Seven deceased COVID-19 patients underwent MIA with brain MR and CT images, six of them with tissue sampling. Imaging findings included infarcts, punctate brain hemorrhagic foci, subarachnoid hemorrhage and signal abnormalities in the splenium, basal ganglia, white matter, hippocampi and posterior cortico-subcortical. Punctate brain hemorrhage was the most common finding (three out of seven cases). Brain histological analysis revealed reactive gliosis, congestion, cortical neuron eosinophilic degeneration and axonal disruption in all six cases. Other findings included edema (5 cases), discrete perivascular hemorrhages (5), cerebral small vessel disease (3), perivascular hemosiderin deposits (3), Alzheimer type II glia (3), abundant corpora amylacea (3), ischemic foci (1), periventricular encephalitis foci (1), periventricular vascular ectasia (1) and fibrin thrombi (1). SARS-CoV-2 RNA was detected with RT-PCR in 5 out of 5 and IHC in 6 out 6 patients (100%). Conclusions Despite limited sampling, MIA was an effective tool to evaluate underlying pathological brain changes in deceased COVID-19 patients. Imaging findings were varied, and pathological features corroborated signs of hypoxia, alterations related to systemic critically ill and SARS-CoV-2 brain invasion. |
| first_indexed | 2024-04-11T18:30:55Z |
| format | Article |
| id | doaj.art-675d8825f04b4939aca42e00ec34272a |
| institution | Directory Open Access Journal |
| issn | 1869-4101 |
| language | English |
| last_indexed | 2024-04-11T18:30:55Z |
| publishDate | 2022-01-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Insights into Imaging |
| spelling | doaj.art-675d8825f04b4939aca42e00ec34272a2022-12-22T04:09:26ZengSpringerOpenInsights into Imaging1869-41012022-01-0113111210.1186/s13244-021-01144-wPostmortem brain 7T MRI with minimally invasive pathological correlation in deceased COVID-19 subjectsMaria da Graça Morais Martin0Vitor Ribeiro Paes1Ellison Fernando Cardoso2Carlos Eduardo Borges Passos Neto3Cristina Takami Kanamura4Claudia da Costa Leite5Maria Concepcion Garcia Otaduy6Renata Aparecida de Almeida Monteiro7Thais Mauad8Luiz Fernando Ferraz da Silva9Luiz Henrique Martins Castro10Paulo Hilario Nascimento Saldiva11Marisa Dolhnikoff12Amaro Nunes Duarte-Neto13Instituto de Radiologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, LIM44Departamento de Patologia, Faculdade de Medicina FMUSP, Universidade de São PauloInstituto de Radiologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, LIM44Neurology Department, Faculdade de Medicina FMUSP, Universidade de São PauloInstituto Adolfo LutzDepartamento de Radiologia e Oncologia, Faculdade de Medicina, Universidade de São PauloInstituto de Radiologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, LIM44Departamento de Patologia, Faculdade de Medicina FMUSP, Universidade de São PauloDepartamento de Patologia, Faculdade de Medicina FMUSP, Universidade de São PauloDepartamento de Patologia, Faculdade de Medicina FMUSP, Universidade de São Paulo, Servico de Verificaçao de Óbitos de São Paulo (SVO)Neurology Department, Faculdade de Medicina FMUSP, Universidade de São PauloDepartamento de Patologia, Faculdade de Medicina FMUSP, Universidade de São PauloDepartamento de Patologia, Faculdade de Medicina FMUSP, Universidade de São PauloDepartamento de Patologia, Faculdade de Medicina FMUSP, Universidade de São PauloAbstract Background Brain abnormalities are a concern in COVID-19, so we used minimally invasive autopsy (MIA) to investigate it, consisting of brain 7T MR and CT images and tissue sampling via transethmoidal route with at least three fragments: the first one for reverse transcription polymerase chain reaction (RT-PCR) analysis and the remaining fixed and stained with hematoxylin and eosin. Two mouse monoclonal anti-coronavirus (SARS-CoV-2) antibodies were employed in immunohistochemical (IHC) reactions. Results Seven deceased COVID-19 patients underwent MIA with brain MR and CT images, six of them with tissue sampling. Imaging findings included infarcts, punctate brain hemorrhagic foci, subarachnoid hemorrhage and signal abnormalities in the splenium, basal ganglia, white matter, hippocampi and posterior cortico-subcortical. Punctate brain hemorrhage was the most common finding (three out of seven cases). Brain histological analysis revealed reactive gliosis, congestion, cortical neuron eosinophilic degeneration and axonal disruption in all six cases. Other findings included edema (5 cases), discrete perivascular hemorrhages (5), cerebral small vessel disease (3), perivascular hemosiderin deposits (3), Alzheimer type II glia (3), abundant corpora amylacea (3), ischemic foci (1), periventricular encephalitis foci (1), periventricular vascular ectasia (1) and fibrin thrombi (1). SARS-CoV-2 RNA was detected with RT-PCR in 5 out of 5 and IHC in 6 out 6 patients (100%). Conclusions Despite limited sampling, MIA was an effective tool to evaluate underlying pathological brain changes in deceased COVID-19 patients. Imaging findings were varied, and pathological features corroborated signs of hypoxia, alterations related to systemic critically ill and SARS-CoV-2 brain invasion.https://doi.org/10.1186/s13244-021-01144-wCOVID-19NeuroimagingMRIAutopsyNeuropathology |
| spellingShingle | Maria da Graça Morais Martin Vitor Ribeiro Paes Ellison Fernando Cardoso Carlos Eduardo Borges Passos Neto Cristina Takami Kanamura Claudia da Costa Leite Maria Concepcion Garcia Otaduy Renata Aparecida de Almeida Monteiro Thais Mauad Luiz Fernando Ferraz da Silva Luiz Henrique Martins Castro Paulo Hilario Nascimento Saldiva Marisa Dolhnikoff Amaro Nunes Duarte-Neto Postmortem brain 7T MRI with minimally invasive pathological correlation in deceased COVID-19 subjects Insights into Imaging COVID-19 Neuroimaging MRI Autopsy Neuropathology |
| title | Postmortem brain 7T MRI with minimally invasive pathological correlation in deceased COVID-19 subjects |
| title_full | Postmortem brain 7T MRI with minimally invasive pathological correlation in deceased COVID-19 subjects |
| title_fullStr | Postmortem brain 7T MRI with minimally invasive pathological correlation in deceased COVID-19 subjects |
| title_full_unstemmed | Postmortem brain 7T MRI with minimally invasive pathological correlation in deceased COVID-19 subjects |
| title_short | Postmortem brain 7T MRI with minimally invasive pathological correlation in deceased COVID-19 subjects |
| title_sort | postmortem brain 7t mri with minimally invasive pathological correlation in deceased covid 19 subjects |
| topic | COVID-19 Neuroimaging MRI Autopsy Neuropathology |
| url | https://doi.org/10.1186/s13244-021-01144-w |
| work_keys_str_mv | AT mariadagracamoraismartin postmortembrain7tmriwithminimallyinvasivepathologicalcorrelationindeceasedcovid19subjects AT vitorribeiropaes postmortembrain7tmriwithminimallyinvasivepathologicalcorrelationindeceasedcovid19subjects AT ellisonfernandocardoso postmortembrain7tmriwithminimallyinvasivepathologicalcorrelationindeceasedcovid19subjects AT carloseduardoborgespassosneto postmortembrain7tmriwithminimallyinvasivepathologicalcorrelationindeceasedcovid19subjects AT cristinatakamikanamura postmortembrain7tmriwithminimallyinvasivepathologicalcorrelationindeceasedcovid19subjects AT claudiadacostaleite postmortembrain7tmriwithminimallyinvasivepathologicalcorrelationindeceasedcovid19subjects AT mariaconcepciongarciaotaduy postmortembrain7tmriwithminimallyinvasivepathologicalcorrelationindeceasedcovid19subjects AT renataaparecidadealmeidamonteiro postmortembrain7tmriwithminimallyinvasivepathologicalcorrelationindeceasedcovid19subjects AT thaismauad postmortembrain7tmriwithminimallyinvasivepathologicalcorrelationindeceasedcovid19subjects AT luizfernandoferrazdasilva postmortembrain7tmriwithminimallyinvasivepathologicalcorrelationindeceasedcovid19subjects AT luizhenriquemartinscastro postmortembrain7tmriwithminimallyinvasivepathologicalcorrelationindeceasedcovid19subjects AT paulohilarionascimentosaldiva postmortembrain7tmriwithminimallyinvasivepathologicalcorrelationindeceasedcovid19subjects AT marisadolhnikoff postmortembrain7tmriwithminimallyinvasivepathologicalcorrelationindeceasedcovid19subjects AT amaronunesduarteneto postmortembrain7tmriwithminimallyinvasivepathologicalcorrelationindeceasedcovid19subjects |