SARS-CoV-2 infection and persistence in the human body and brain at autopsy.
Level 4 - case-series / case-control
Autopsy case series evaluating post-mortem tissue distribution across 44 individuals.
PubMed 36517603 · doi:10.1038/s41586-022-05542-y
What was done
Researchers conducted comprehensive autopsies on 44 patients who died with COVID-19, including extensive central nervous system tissue sampling in 11 individuals. They mapped and quantified the distribution, viral replication, and cell-type specificity of SARS-CoV-2 across multiple organ systems and the brain, spanning intervals from acute infection to over seven months following symptom onset.
What was found
SARS-CoV-2 RNA was widely distributed across respiratory and non-respiratory tissues, including the brain, with early-phase evidence of active replication. Viral RNA persisted across multiple anatomical sites up to 230 days post-symptom onset in one patient. Despite widespread systemic and central nervous system viral dissemination, little evidence of direct viral cytopathology or significant inflammation was observed outside the respiratory tract.
Why it matters
This study provides direct physical evidence that SARS-CoV-2 can disseminate systemically beyond the respiratory tract and persist in tissues, including the brain, for months after symptom onset.
Limits
The study is restricted to a post-mortem cohort of patients who died with severe COVID-19 (n=44, with brain sampling in n=11), limiting generalizability to mild, moderate, or surviving individuals. Long-term persistence at 230 days reflects a single case observation, and functional cellular consequences cannot be fully assessed post-mortem.
Cited by
- supports SARS-CoV-2 has been detected in human heart tissue, brain tissue, cerebrospinal fluid, kidneys, gastrointestinal tract, testes, and blood plasma.