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Genchi, Angela; Semerano, Aurora; Schwarz, Ghil; Dell'Acqua, Beatrice; Gullotta, Giorgia Serena; Sampaolo, Michela; Boeri, Enzo; Quattrini, Angelo; Sanvito, Francesca; Diamanti, Susanna; Bergamaschi, Andrea; Grassi, Stefano; Podini, Paola; Panni, Pietro; Michelozzi, Caterina; Simionato, Franco; Scomazzoni, Francesco; Remida, Paolo; Valvassori, Luca; Falini, Andrea; Ferrarese, Carlo; Michel, Patrik; Saliou, Guillaume; Hajdu, Steven; Beretta, Simone; Roveri, Luisa; Filippi, Massimo; Strambo, Davide; Martino, Gianvito; Bacigaluppi, Marco
Acta neuropathologica communications, 02/2022, Letnik: 10, Številka: 1Journal Article
Coronavirus disease 2019 (COVID-19) is associated with an increased risk of thrombotic events. Ischemic stroke in COVID-19 patients entails high severity and mortality rates. Here we aimed to analyze cerebral thrombi of COVID-19 patients with large vessel occlusion (LVO) acute ischemic stroke to expose molecular evidence for SARS-CoV-2 in the thrombus and to unravel any peculiar immune-thrombotic features. We conducted a systematic pathological analysis of cerebral thrombi retrieved by endovascular thrombectomy in patients with LVO stroke infected with COVID-19 (n = 7 patients) and non-covid LVO controls (n = 23). In thrombi of COVID-19 patients, the SARS-CoV-2 docking receptor ACE2 was mainly expressed in monocytes/macrophages and showed higher expression levels compared to controls. Using polymerase chain reaction and sequencing, we detected SARS-CoV-2 Clade20A, in the thrombus of one COVID-19 patient. Comparing thrombus composition of COVID-19 and control patients, we noted no overt differences in terms of red blood cells, fibrin, neutrophil extracellular traps (NETs), von Willebrand Factor (vWF), platelets and complement complex C5b-9. However, thrombi of COVID-19 patients showed increased neutrophil density (MPO cells) and a three-fold higher Neutrophil-to-Lymphocyte Ratio (tNLR). In the ROC analysis both neutrophils and tNLR had a good discriminative ability to differentiate thrombi of COVID-19 patients from controls. In summary, cerebral thrombi of COVID-19 patients can harbor SARS-CoV2 and are characterized by an increased neutrophil number and tNLR and higher ACE2 expression. These findings suggest neutrophils as the possible culprit in COVID-19-related thrombosis.
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JCR | SNIP | JCR | SNIP | JCR | SNIP | JCR | SNIP |
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Vir: Osebne bibliografije
in: SICRIS
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