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Detailed neuropathologic report of COVID-19 complicated by large intracerebral hemorrhage and periventricular lesions with macrophagic infiltrates Levine, Adrian; Lee, Carol; Fava, Craig; Tsang, Frankie; MacNeil, Kelly; Yip, Stephen; Hirsch-Reinshagen, Veronica

Abstract

Infection with the SARS-CoV-2 virus affects a wide range of systems. Significant involvement of the central nervous system has been described, including ischemic and hemorrhagic strokes. Thus far, neuropathologic reports of patients who passed away from COVID-19 have generally described non-specific findings, such as variable reactive gliosis and meningeal chronic inflammatory infiltrates, as well as the consequences of the infection’s systemic complications on the brain, including ischemic infarcts and hypoxic/ischemic encephalopathy. The neuropathological changes in patients with COVID-19 and large hemorrhagic strokes have not been described in detail. We report the case of an elderly male who had a long course of COVID-19 and ultimately passed away from a large intracerebral hemorrhage. In addition to acute hemorrhage, neuropathologic examination demonstrated non-specific reactive changes and chronic periventricular lesions with macrophagic and perivascular lymphocytic infiltrates without evidence of demyelination or presence of SARS-CoV-2 by PCR test. This manuscript expands the spectrum of reported neuropathological changes in patients with COVID-19.

Item Metadata

Title
Detailed neuropathologic report of COVID-19 complicated by large intracerebral hemorrhage and periventricular lesions with macrophagic infiltrates
Creator
Levine, Adrian; Lee, Carol; Fava, Craig; Tsang, Frankie; MacNeil, Kelly; Yip, Stephen; Hirsch-Reinshagen, Veronica
Publisher
University of Münster
Date Issued
2021-03-25
Description
Infection with the SARS-CoV-2 virus affects a wide range of systems. Significant involvement of the central nervous system has been described, including ischemic and hemorrhagic strokes. Thus far, neuropathologic reports of patients who passed away from COVID-19 have generally described non-specific findings, such as variable reactive gliosis and meningeal chronic inflammatory infiltrates, as well as the consequences of the infection’s systemic complications on the brain, including ischemic infarcts and hypoxic/ischemic encephalopathy. The neuropathological changes in patients with COVID-19 and large hemorrhagic strokes have not been described in detail. We report the case of an elderly male who had a long course of COVID-19 and ultimately passed away from a large intracerebral hemorrhage. In addition to acute hemorrhage, neuropathologic examination demonstrated non-specific reactive changes and chronic periventricular lesions with macrophagic and perivascular lymphocytic infiltrates without evidence of demyelination or presence of SARS-CoV-2 by PCR test. This manuscript expands the spectrum of reported neuropathological changes in patients with COVID-19.
Subject
COVID-19; Cerebral hemorrhage; Brain; Postmortem; Histology; Neuropathology
Genre
Article
Type
Text
Language
eng
Date Available
2021-07-07
Provider
Vancouver : University of British Columbia Library
Rights
Attribution 4.0 International
DOI
10.14288/1.0400059
URI
http://hdl.handle.net/2429/78874
Affiliation
Medicine, Faculty of; Non UBC; Pathology and Laboratory Medicine, Department of
Citation
Levine, A., Lee, C., Fava, C., Tsang, F., McNeil, K., Yip, S. T., & Hirsch-Reinshagen, V. (2021). Detailed neuropathologic report of COVID-19 complicated by large intracerebral hemorrhage and periventricular lesions with macrophagic infiltrates. Free Neuropathology, 2, 7.
Publisher DOI
10.17879/freeneuropathology-2021-3266
Peer Review Status
Reviewed
Scholarly Level
Faculty; Researcher
Copyright Holder
Authors
Rights URI
http://creativecommons.org/licenses/by/4.0/
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Attribution 4.0 International