Neuropathological findings in COVID-19 vs. non-COVID-19 acute respiratory distress syndrome-A case-control study.
Level 4 - case-series / case-control
Matched case-control autopsy study
PubMed 38187146 · doi:10.3389/fneur.2023.1283698
What was done
This was an age- and sex-matched case-control autopsy study conducted at a tertiary academic center. Neuropathological autopsy findings were compared between 10 patients with COVID-19 acute respiratory distress syndrome (ARDS) and 20 matched control patients with non-COVID-19 ARDS.
What was found
Baseline demographics and ARDS severity were comparable between groups (p = 0.3). Frequency of overall acute brain injury (70% vs. 60%), infratentorial acute brain injury (40% vs. 25%), ischemic infarct (40% vs. 25%), intracranial hemorrhage (30% vs. 35%), and hypoxic-ischemic brain injury (30% vs. 35%) did not significantly differ between COVID-19 and non-COVID-19 ARDS patients (all p > 0.05). Intracapillary megakaryocytes were exclusively seen in 30% of COVID-19 patients.
Why it matters
The findings suggest that acute brain injury patterns in fatal COVID-19 ARDS largely mirror those of non-COVID-19 ARDS rather than representing a distinct presentation.
Limits
The sample size is very small (10 cases, 20 controls) from a single center. The study only includes fatal ARDS cases, which may not generalize to non-fatal disease.
Cited by
- supports Neuropathological evaluations of COVID-19 patient brains show microthrombosis, microhemorrhage, inflammatory cells, and megakaryocytes.