Thread by @yaneerbaryam

NIH Study: "SARS-CoV-2 is widely distributed, even among patients who died with asymptomatic to mild COVID-19, and that virus replication is present in multiple extrapulmonary tissues early in infection...[and] throughout the brain for up to 230 days

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researchsquare.com/article/rs-113…

"We show SARS-CoV-2 disseminates across the human body and brain early in infection at high levels, and provide evidence of virus replication at multiple extrapulmonary [outside the lungs] sites during the first week following symptom onset.

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"We demonstrate conclusively that SARS-CoV-2 is capable of infecting and replicating within ... the heart, lymph node, small intestine, and adrenal gland...high levels of SARS-CoV-2 RNA and evidence of
replication in colon, lymphoid tissues, and ocular tissues.

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"...as well as SARS-CoV-2 RNA ... in colonic mucosal
epithelium and mononuclear leukocytes within the spleen, thoracic cavity lymph nodes, and GI lymphoid aggregates

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"Our results collectively show while that the highest burden of SARS-CoV-2 is in the airways and lung, the virus can disseminate early during infection and infect cells throughout the entire body, including widely throughout the brain.

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"Our findings, therefore, suggest ... body-wide dissemination, including across the blood-brain barrier, and viral replication can occur early in COVID-19, even in asymptomatic or mild cases.

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"Further, P[atient]36 was a juvenile with no evidence of multisystem inflammatory syndrome in children, suggesting infected children without severe COVID-19 can also experience systemic infection with SARS-CoV-2.

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"Finally, a major contribution of our work is a greater understanding of the duration and locations at which SARS-CoV-2 can persist.

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"While respiratory tract was most common location in which SARS-CoV-2 tends to linger, ≥50% of late cases also had persistence in myocardium, thoracic cavity lymph nodes, tongue, peripheral nerves, ocular tissue, and in all sampled areas of the brain, except the dura mater.

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"Interestingly, despite having much lower levels of SARS-CoV-2 in early cases compared to respiratory tissues, we found similar levels between pulmonary and the extrapulmonary tissue categories in late cases.

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"We detected sgRNA in tissue of over 60% of the cohort.

"These data ... suggest that SARS-CoV-2 can replicate within tissue for over 3 months after infection in some individuals, with RNA failing to clear from multiple compartments for up to 230 days.

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