Assessing Brain Capillaries in Coronavirus Disease 2019 | Infectious Diseases | JAMA Neurology | JAMA Network
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    Research Letter
    February 12, 2021

    Assessing Brain Capillaries in Coronavirus Disease 2019

    Author Affiliations
    • 1Department of Pathology, Johns Hopkins University, Baltimore, Maryland
    • 2Department of Otolaryngology, Johns Hopkins University, Baltimore, Maryland
    • 3Department of Pathology, Brigham and Women’s Hospital, Boston, Massachusetts
    JAMA Neurol. Published online February 12, 2021. doi:10.1001/jamaneurol.2021.0225

    Evidence suggests brain involvement in coronavirus disease 2019 (COVID-19). Manifestations in acutely ill individuals often include confusion and alteration of consciousness. After this phase, many patients experience continued neurologic symptoms such as dysexecutive syndrome1 or “brain fog.”2 However, in autopsies from patients with COVID-19 who had neurologic abnormalities (reviewed in the study by Mukerji and Solomon3), investigations have largely not identified the chronic inflammation or marked neural changes typically associated with viral infection, and viral genetic material has been minimal or absent. It has been difficult to reconcile the experience of patients and clinicians that COVID-19 is altering cognition with tissue studies that show no evidence of encephalitis involving higher brain centers. We hypothesized that histopathology might provide insight. We report here a finding that may contribute in some cases, identified by analysis of brain tissue from patients who died of COVID-19.

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