Frontiers in Neurology (Dec 2023)

Neuropathological findings in COVID-19 vs. non-COVID-19 acute respiratory distress syndrome—A case-control study

  • Mariyam Humayun,
  • Lucy Zhang,
  • Thomas D. Zaikos,
  • Nivedha Kannapadi,
  • Jose I. Suarez,
  • David N. Hager,
  • Juan C. Troncoso,
  • Sung-Min Cho

DOI
https://doi.org/10.3389/fneur.2023.1283698
Journal volume & issue
Vol. 14

Abstract

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Acute brain injury (ABI) and neuroinflammation is reported in COVID-19 and acute respiratory distress syndrome (ARDS). It remains unclear if COVID-19 plays an independent role in development of ABI compared to those with non-COVID-19 ARDS. We aimed to evaluate if COVID-19 ARDS is associated with higher risk and specific patterns of ABI compared to non-COVID-19 ARDS. We conducted an age and sex matched case-control autopsy study at a tertiary academic center. Ten patients with COVID-19 ARDS were matched to 20 non-COVID-19 ARDS patients. Baseline demographics were comparable between the two groups including severity of ARDS (p = 0.3). The frequency of overall ABI (70 vs. 60%), infratentorial ABI (40 vs. 25%), ischemic infarct (40 vs. 25%), intracranial hemorrhage (30 vs. 35%), and hypoxic-ischemic brain injury (30 vs. 35%) was similar between COVID-19 and non-COVID-19 ARDS patients, respectively (p > 0.05). Intracapillary megakaryocytes were exclusively seen in 30% of COVID-19 patients. Overall, frequency and pattern of ABI in COVID-19 ARDS was comparable to non-COVID-19.

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