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<h2 class="element-invisible">You are here</h2><div class="breadcrumb"><a href="/">Home</a> » <a href="/news-events">News & Events</a> » <a href="/news-events/news-releases">News Releases</a></div> <div class="l-region l-region--section-header">
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<div about="/news-events/news-releases/nih-study-uncovers-blood-vessel-damage-inflammation-covid-19-patients-brains-no-infection" typeof="sioc:Item foaf:Document" class="ds-1col node node--nih-news-release news-release featured-media-floated view-mode-full node--full node--nih-news-release--full clearfix">
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<p class="publishdate"><span class="tag-term">News Release</span></p><p class="publishdate"><span property="dc:date" datatype="xsd:dateTime" content="2020-12-30T17:00:00-05:00" class="date-display-single">Wednesday, December 30, 2020</span></p><h1>NIH study uncovers blood vessel damage and inflammation in COVID-19 patients’ brains but no infection</h1><p class="subtitle">
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Results from a study of 19 deceased patients suggests brain damage is a byproduct of a patient’s illness.</p><div class="featured-media"><div class="ds-1col file file-image file-image-jpeg view-mode-featured_media clearfix">
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<picture title="Scan of deceased COVID-19 patient’s brain">
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<!--[if IE 9]><video style="display: none;"><![endif]-->
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<source srcset="https://www.nih.gov/sites/default/files/styles/featured_media_breakpoint-large-extra/public/news-events/news-releases/2020/20201230-brain.jpg?itok=YpoJ-qGi&timestamp=1609358723 1x" media="screen and (min-width: 1100px)" />
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<source srcset="https://www.nih.gov/sites/default/files/styles/featured_media_breakpoint-large/public/news-events/news-releases/2020/20201230-brain.jpg?itok=JF2goK01&timestamp=1609358723 1x" media="screen and (min-width: 960px)" />
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<source srcset="https://www.nih.gov/sites/default/files/styles/featured_media_breakpoint-medium/public/news-events/news-releases/2020/20201230-brain.jpg?itok=CH1cxUWe&timestamp=1609358723 1x" media="screen and (min-width: 800px)" />
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<source srcset="https://www.nih.gov/sites/default/files/styles/featured_media_breakpoint-medium-small/public/news-events/news-releases/2020/20201230-brain.jpg?itok=LyabrQhL&timestamp=1609358723 1x" media="screen and (min-width: 600px)" />
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<source srcset="https://www.nih.gov/sites/default/files/styles/featured_media_breakpoint-small/public/news-events/news-releases/2020/20201230-brain.jpg?itok=wfObPN3f&timestamp=1609358723 1x" media="screen and (min-width: 480px)" />
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<source srcset="https://www.nih.gov/sites/default/files/styles/featured_media__breakpoint-tiny_/public/news-events/news-releases/2020/20201230-brain.jpg?itok=StYZdDmm&timestamp=1609358723 1x" media="screen and (min-width: 0)" />
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<!--[if IE 9]></video><![endif]-->
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<img src="https://www.nih.gov/sites/default/files/styles/featured_media_breakpoint-medium/public/news-events/news-releases/2020/20201230-brain.jpg?itok=CH1cxUWe&timestamp=1609358723" alt="Scan of deceased COVID-19 patient’s brain" title="Scan of deceased COVID-19 patient’s brain" />
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||
</picture><span class="caption">NIH researchers consistently found blood vessel damage in the brains of COVID-19 patients but no signs of SARS-CoV-2 infections. Arrows point to light and dark spots that are indicative of blood vessel damage observed in the study. </span><span class="credit">NIAID</span></div>
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</div><p>In an in-depth study of how COVID-19 affects a patient’s brain, National Institutes of Health researchers consistently spotted hallmarks of damage caused by thinning and leaky brain blood vessels in tissue samples from patients who died shortly after contracting the disease. In addition, they saw no signs of SARS-CoV-2 in the tissue samples, suggesting the damage was not caused by a direct viral attack on the brain. The results were published as a correspondence in the New England Journal of Medicine.</p>
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<p>“We found that the brains of patients who contract infection from SARS-CoV-2 may be susceptible to microvascular blood vessel damage. Our results suggest that this may be caused by the body’s inflammatory response to the virus” said Avindra Nath, M.D., clinical director at the NIH’s National Institute of Neurological Disorders and Stroke (<a href="https://www.ninds.nih.gov/">NINDS</a>) and the senior author of the study. “We hope these results will help doctors understand the full spectrum of problems patients may suffer so that we can come up with better treatments.”</p>
|
||
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||
<p>Although COVID-19 is primarily a respiratory disease, patients often experience neurological problems including headaches, delirium, cognitive dysfunction, dizziness, fatigue, and loss of the sense of smell. The disease may also cause patients to suffer strokes and other neuropathologies.</p>
|
||
|
||
<p>Several studies have shown that the disease can cause inflammation and blood vessel damage. In one of these <a href="https://pubmed.ncbi.nlm.nih.gov/33257876/">studies</a>, the researchers found evidence of small amounts of SARS-CoV-2 in some patients’ brains. Nevertheless, scientists are still trying to understand how the disease affects the brain.</p>
|
||
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||
<p>In this study, the researchers conducted an in-depth examination of brain tissue samples from 19 patients who had died after experiencing COVID-19 between March and July 2020. Samples from 16 of the patients were provided by the Office of the Chief Medical Examiner in New York City while the other 3 cases were provided by the department of pathology at the University of Iowa College of Medicine, Iowa City. The patients died at a wide range of ages, from 5 to 73 years old. They died within a few hours to two months after reporting symptoms. Many patients had one or more risk factors, including diabetes, obesity, and cardiovascular disease. Eight of the patients were found dead at home or in public settings. Another three patients collapsed and died suddenly.</p>
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||
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||
<p>Initially, the researchers used a special, high-powered magnetic resonance imaging (MRI) scanner that is 4 to 10 times more sensitive than most MRI scanners, to examine samples of the olfactory bulbs and brainstems from each patient. These regions are thought to be highly susceptible to COVID-19. Olfactory bulbs control our sense of smell while the brainstem controls our breathing and heart rate. The scans revealed that both regions had an abundance of bright spots, called hyperintensities, that often indicate inflammation, and dark spots, called hypointensities, that represent bleeding.</p>
|
||
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||
<p>The researchers then used the scans as a guide to examine the spots more closely under a microscope. They found that the bright spots contained blood vessels that were thinner than normal and sometimes leaking blood proteins, like fibrinogen, into the brain. This appeared to trigger an immune reaction. The spots were surrounded by T cells from the blood and the brain’s own immune cells called microglia. In contrast, the dark spots contained both clotted and leaky blood vessels but no immune response.</p>
|
||
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||
<p>“We were completely surprised. Originally, we expected to see damage that is caused by a lack of oxygen. Instead, we saw multifocal areas of damage that is usually associated with strokes and neuroinflammatory diseases,” said Dr. Nath.</p>
|
||
|
||
<p>Finally, the researchers saw no signs of infection in the brain tissue samples even though they used several methods for detecting genetic material or proteins from SARS-CoV-2.</p>
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||
<p>“So far, our results suggest that the damage we saw may not have been not caused by the SARS-CoV-2 virus directly infecting the brain,” said Dr. Nath. “In the future, we plan to study how COVID-19 harms the brain’s blood vessels and whether that produces some of the short- and long-term symptoms we see in patients.”</p>
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<p>This study was supported by NIH Intramural Research Program at the National Institute of Neurological Disorders and Stroke (<a href="https://projectreporter.nih.gov/project_info_description.cfm?aid=10265882&icde=53030260&ddparam=&ddvalue=&ddsub=&cr=1&csb=default&cs=ASC&pball=">NS003130</a>) and an NIH grant (<a href="https://projectreporter.nih.gov/project_info_description.cfm?aid=10020444&icde=53030273&ddparam=&ddvalue=&ddsub=&cr=1&csb=default&cs=ASC&pball=">NS109284</a>).</p>
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<p><strong>NINDS</strong> (<a href="https://www.ninds.nih.gov">https://www.ninds.nih.gov</a>) is the nation’s leading funder of research on the brain and nervous system. The mission of NINDS is to seek fundamental knowledge about the brain and nervous system and to use that knowledge to reduce the burden of neurological disease.</p>
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<p><strong>About the National Institute on Aging (NIA): </strong>NIA leads the U.S. federal government effort to conduct and support research on aging and the health and well-being of older people. Learn more about age-related cognitive change and neurodegenerative diseases via NIA’s <a href="https://www.nia.nih.gov/health/alzheimers">Alzheimer's and related Dementias Education and Referral (ADEAR) Center</a> website. For information about a broad range of aging topics, visit the <a href="https://www.nia.nih.gov/research/scientific-review">main NIA website</a> and <a href="https://www.nia.nih.gov/about/stay-connected">stay connected</a>.</p><p><strong>About the National Institutes of Health (NIH):</strong>
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NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit <a href="/">www.nih.gov</a>.</p>
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<p class="slogan"><em>NIH…Turning Discovery Into Health<sup>®</sup></em></p><div about="/field-collection/field-additional-info/37721" class="ds-1col entity entity-field-collection-item field-collection-item-field-additional-info view-mode-full clearfix">
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<h3>Article</h3><p>Lee MH, Perl DP, Nair G, Li W, Maric D, Murray H, Dodd SJ, Koretsky AP, Watts JA, Cheung V, Masliah E, Horkayne-Szakaly I, Jones R, Stram MN, Moncur J, Hefti M, Folkerth RD, Nath A. Microvascular Injury in the Brains of Patients with COVID-19. New England Journal of Medicine, December 30, 2020 DOI: 10.1056/NEJMc2033369.</p></div>
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