TY  - JOUR
AU  - Matschke, Jakob
AU  - Lütgehetmann, Marc
AU  - Hagel, Christian
AU  - Sperhake, Jan P
AU  - Schröder, Ann Sophie
AU  - Edler, Carolin
AU  - Mushumba, Herbert
AU  - Fitzek, Antonia
AU  - Allweiss, Lena
AU  - Dandri, Maura
AU  - Dottermusch, Matthias
AU  - Heinemann, Axel
AU  - Pfefferle, Susanne
AU  - Schwabenland, Marius
AU  - Sumner Magruder, Daniel
AU  - Bonn, Stefan
AU  - Prinz, Marco
AU  - Gerloff, Christian
AU  - Püschel, Klaus
AU  - Krasemann, Susanne
AU  - Aepfelbacher, Martin
AU  - Glatzel, Markus
TI  - Neuropathology of patients with COVID-19 in Germany: a post-mortem case series
JO  - The lancet  / Neurology
VL  - 19
IS  - 11
SN  - 1474-4422
CY  - London
PB  - Lancet Publ. Group
M1  - DZNE-2021-00059
SP  - 919 - 929
PY  - 2020
AB  - Background: Prominent clinical symptoms of COVID-19 include CNS manifestations. However, it is unclear whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19, gains access to the CNS and whether it causes neuropathological changes. We investigated the brain tissue of patients who died from COVID-19 for glial responses, inflammatory changes, and the presence of SARS-CoV-2 in the CNS.Methods: In this post-mortem case series, we investigated the neuropathological features in the brains of patients who died between March 13 and April 24, 2020, in Hamburg, Germany. Inclusion criteria comprised a positive test for SARS-CoV-2 by quantitative RT-PCR (qRT-PCR) and availability of adequate samples. We did a neuropathological workup including histological staining and immunohistochemical staining for activated astrocytes, activated microglia, and cytotoxic T lymphocytes in the olfactory bulb, basal ganglia, brainstem, and cerebellum. Additionally, we investigated the presence and localisation of SARS-CoV-2 by qRT-PCR and by immunohistochemistry in selected patients and brain regions.Findings: 43 patients were included in our study. Patients died in hospitals, nursing homes, or at home, and were aged between 51 years and 94 years (median 76 years [IQR 70-86]). We detected fresh territorial ischaemic lesions in six (14
KW  - Aged
KW  - Aged, 80 and over
KW  - Autopsy: methods
KW  - Betacoronavirus: isolation & purification
KW  - Brain: pathology
KW  - Brain: virology
KW  - COVID-19
KW  - Coronavirus Infections: epidemiology
KW  - Coronavirus Infections: genetics
KW  - Coronavirus Infections: pathology
KW  - Female
KW  - Germany: epidemiology
KW  - Humans
KW  - Male
KW  - Middle Aged
KW  - Neuropathology
KW  - Pandemics
KW  - Pneumonia, Viral: epidemiology
KW  - Pneumonia, Viral: genetics
KW  - Pneumonia, Viral: pathology
KW  - SARS-CoV-2
KW  - Transcriptome: genetics
LB  - PUB:(DE-HGF)16
C2  - pmc:PMC7535629
C6  - pmid:33031735
DO  - DOI:10.1016/S1474-4422(20)30308-2
UR  - https://pub.dzne.de/record/154197
ER  -