由SARS-CoV-2感染引起的脑组织病理变化
Roberta Andreea Cercel1, Florin Ionuţ Buibaş, Mircea Sebastian Şerbănescu
1Department of Neurosurgery, Bagdasar-Arseni Emergency Hospital, Bucharest, Romania; george_popescu39@yahoo.com; Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, Romania; magdalena.manolea@umfcv.ro.
概括
严重急性呼吸道综合征冠状病毒2 (SARS-CoV-2) 导致COVID-19,导致中枢神经系统 (CNS) 损伤. 组织病理学揭示了已故患者的缺血病变,血管血栓和神经元感染,突出了神经系统的影响.
科学领域:
- 神经病理学神经病理学
- 传染性疾病 传染性疾病
- 法医医学 法医医学
背景情况:
- 冠状病毒疾病2019 (COVID-19),由严重急性呼吸系统综合征冠状病毒2 (SARS-CoV-2) 引起,已成为一个重要的全球流行病.
- 虽然最初被认为是一种呼吸系统疾病,但SARS-CoV-2越来越多地与神经表现和系统性影响有关.
- 了解SARS-CoV-2感染的神经病理后果对于了解疾病严重程度和患者结果至关重要.
研究的目的:
- 为了调查和描述死于SARS-CoV-2感染的个体中枢神经系统 (CNS) 的组织病变病变.
- 为了将COVID-19的临床和生物诊断与观察到的大脑病理相关联.
- 在中枢神经系统中识别SARS-CoV-2的特定细胞点.
主要方法:
- 通过RT-PCR检查65个来自36名被诊断为COVID-19的患者的大脑组织碎片的显微镜检查.
- 尸体解剖是为了法医目的而进行的,以确定可疑情况的死亡原因.
- 使用抗尖抗体检测神经和血管组织中的病毒存在的免疫组织化学.
主要成果:
- 最常见的中枢神经系统病变包括缺血性变化,其特点是"红色神经元",神经周周,以及大脑皮层的"海绵状"外观.
- 观察到多重血管血栓,特别是在小血管,内皮细胞破坏,增加血脑屏障的透性,以及内出血.
- 抗抗体染色证实了SARS-CoV-2在大型神经元 (皮层金字塔细胞,小脑Purkinje细胞),内皮细胞,皮质细胞和血管光滑肌细胞中的感染.
结论:
- SARS-CoV-2 感染导致中枢神经系统发生显著的本病学损伤,超过呼吸道症状.
- 缺血性损伤和血管病理,包括血栓形成和血脑屏障破坏,是COVID-19神经病理学的关键特征.
- 该病毒直接感染大脑内的各种神经和血管细胞类型,导致观察到的病变和潜在的神经后续.
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