Neuropathological Findings in the Brains of Deceased COVID-19 Patients

As COVID-19 continues to infect millions of people globally, it is essential to understand how SARS-CoV-2 affects the brain. The purpose of this study is to determine if there are any associations or patterns of gross and microscopic neuropathological autopsy findings in the brains of patients who died from COVID-19. We analyzed 32 autopsy cases that met 3 requirements: (1) positive polymerase chain reaction (PCR) SARS-CoV-2 test at autopsy; (2) pulmonary histological features of SARS-CoV-2; (3) complete autopsies conducted during the COVID-19 pandemic from 2020 to 2023. We accounted for the presence of the following gross and microscopic neuropathological findings: cerebral edema (CE), cerebral cortical atrophy (CCA), chronic cerebrovascular disease (CCD), cerebral ischemic injury (CII), cerebral inflammation (CIN), and/or cerebral parenchymal hemorrhage (CPH) in every case. We found that CE, CCA, and CII diagnoses had a statistically significant association with age. There were no distinctive or recurrent neuropathological alterations in the autopsied brains that may be interpreted to be pathognomonic of SARS-CoV-2 infection in our cohort. These findings may suggest that SARS-CoV-2 infection is not associated with any distinct histomorphologic abnormalities that are diagnostic of COVID-19 in the brains of autopsied patients.