Update on the ISN COVID-19 collaborative efforts – message from the President Prof Seth Love
Thank you to all colleagues around the globe who have been sharing their expertise and ideas as to how best we might contribute to efforts to understand the neurological complications of COVID-19.
As listed below, neuropathologists in a number of centres have received brains from patients with COVID-19 and have agreed to be contacted by researchers interested in obtaining tissue for analysis.
We are in the process of putting together a small task force of colleagues with interest and expertise in the field who are helping to advise on neuropathological research priorities and to suggest how the ISN might help with these. There is agreement that:
1. At present it remains unclear as to whether SARS CoV-2 definitely spreads to the CNS and, if so, whether it does so after haematogenous spread, by binding to ACE2 receptors (which seem to be expressed mostly by endothelial cells in the brain), or by some form of olfactory pathway invasion, perhaps accounting for early loss of the ability to smell and taste in some patients.
2. The subacute (e.g. immune-mediated) and longer-term effects on the nervous system (including the possibility of recrudescent disease) are also of considerable interest.
3. We know little about the effects of the virus on peripheral nerves, and cardiac and skeletal muscle.
4. We suggest that neuropathologists with access to post-mortem brains from patients with SARS CoV-2 infection should sample the brain widely to look for evidence of infection, and should ensure that the sampling includes regions involved in smell and taste (olfactory bulbs and tracts, orbitofrontal cortex, and insula together with adjacent parietal and temporal operculum).
5. If possible, samples of peripheral nerves, and cardiac and skeletal muscle should also be retained.
Please find a link to the UK Royal College of Pathologists guidance to histopathologists / neuropathologists for handling unfixed tissue from COVID-10 patients. Similar advice will increasingly be available for individual countries (please also consult your local guidance if available)
Please contact these centres directly to request access to tissue for collaborative research projects.
Dr Safa Al-Sarraj Kings College Hospital Brain Bank London UK Email: safa.al-sarraj@nhs.net
Dr Stephan Frank University of Basel Basel Switzerland Email: stephan.frank@usb.ch
Dr Ian Mackenzie University of British Columbia Vancouver Canada Email: ian.mackenzie@vch.ca
Dr Danielle Seilhean* Sorbonne Université Paris France Email: danielle.seilhean@upmc.fr *please use request formÂ
Dr Michael Osborn** Imperial College Healthcare Trust London UK Email: d.walsh@imperial.ac.uk and michael.osborn@nhs.net **Please use request form
Other centres wishing to be listed should contact the ISN secretary, Monika Hofer (monika.hofer@ouh.nhs.uk).