An Autopsy Report of a Case with Cerebral Infarction Complicated by Coronavirus Disease 2019 Infection

Ryoji Goto; Haruka Kawakami; Yurino Horiuchi; Ayaka Chikada; Tsutomu Yasuda; Tetsuya Suzuki; Yusuke Miyazato; Masahiro Ishikane; Yuya Kishino; Hideki Miyazaki; Toru Igari; Harutaka Katano; Tadaki Suzuki; Shigeo Murayama; Noritoshi Arai

doi:10.2169/internalmedicine.9726-22

CASE REPORTS

An Autopsy Report of a Case with Cerebral Infarction Complicated by Coronavirus Disease 2019 Infection

Ryoji Goto, Haruka Kawakami, Yurino Horiuchi, Ayaka Chikada, Tsutomu Yasuda, Tetsuya Suzuki, Yusuke Miyazato, Masahiro Ishikane, Yuya Kishino, Hideki Miyazaki, Toru Igari, Harutaka Katano, Tadaki Suzuki, Shigeo Murayama, Noritoshi Arai

Author information

Ryoji Goto
Department of Neurology, National Center for Global Health and Medicine, Japan
Department of Neurology, Tokyo Metropolitan Geriatric Hospital, Japan
Haruka Kawakami
Department of Neurology, National Center for Global Health and Medicine, Japan
Yurino Horiuchi
Department of Neurology, National Center for Global Health and Medicine, Japan
Ayaka Chikada
Department of Neurology, National Center for Global Health and Medicine, Japan
Tsutomu Yasuda
Department of Neurology, National Center for Global Health and Medicine, Japan
Tetsuya Suzuki
Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan
Yusuke Miyazato
Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan
Masahiro Ishikane
Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan
Yuya Kishino
Department of Pathology, National Center for Global Health and Medicine, Japan
Department of Pathology, Graduate School of Medicine, the University of Tokyo, Japan
Hideki Miyazaki
Department of Pathology, National Center for Global Health and Medicine, Japan
Toru Igari
Department of Pathology, National Center for Global Health and Medicine, Japan
Harutaka Katano
Department of Pathology, National Institute of Infectious Diseases, Japan
Tadaki Suzuki
Department of Pathology, National Institute of Infectious Diseases, Japan
Shigeo Murayama
Brain Bank for Neurodevelopmental, Neurological and Psychiatric Disorders, Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Japan
Brain Bank for Aging Research, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Japan
Noritoshi Arai
Department of Neurology, National Center for Global Health and Medicine, Japan

Keywords: coronavirus disease 2019 (COVID-19), neuroinfectious disease, thrombus, infarction, stroke

JOURNAL OPEN ACCESS

2022 Volume 61 Issue 22 Pages 3439-3444

DOI https://doi.org/10.2169/internalmedicine.9726-22

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Abstract

We herein report a case of cerebral infarct in a patient with coronavirus disease 2019 (COVID-19) infection who died of aspiration pneumonia. The postmortem examination of the brain revealed embolic infarct with negative findings on quantitative reverse transcription polymerase chain reaction (qRT-PCR) as well as immunohistochemistry to detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The systemic examination only revealed low copy numbers of SARS-CoV-2 in the bronchus. This is the first and so far only autopsy case of COVID-19 infection with pathologic and virologic findings of the postmortem brain in Japan.

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