Kaleidoscope - Volume 222 , Issue 3

Tracy, Derek K.; Albertson, Dawn N.; Sri, Anna; Shergill, Sukhwinder S.

Abstract

We continue to count the ongoing costs of COVID-19, with an increasing emphasis on ‘long covid’ and enduring systemic effects. Writing in Nature, Stein et alReference Stein, Ramelli, Grazioli, Chung, Singh and Yinda1 undertook autopsies on 44 unvaccinated people who had died in the year to March 2021, including sampling multiple sites in the central nervous system. Their aim was to map the persistence, distribution, replication competence and cell-type specificity of any identified virus in individuals whose time of death varied from shortly after infection to 7 months later. The patterns differed across those sampled, but the virus was widely distributed in their bodies, including in non-respiratory tissue, and it was often present in the brain, even early in infection. The systemic distribution was greater in those who had died with severe COVID-19, and it was noteworthy that there was persistent viral RNA in brain tissue up to 230 days after initial symptomatology. Fascinatingly, and perhaps somewhat concerningly, there was little evidence of inflammation or direct viral cytopathology beyond the respiratory tract despite the ongoing presence of the virus. The authors posit that there might be altered interferon signalling or disrupted antigen processing and presentation, and subsequently less efficient viral clearance in extra-respiratory tissue. This may have important implications for future therapeutics aimed at facilitating viral clearance. In this still rapidly moving environment, not least with continuing virus mutations and varying population patterns and numbers of those vaccinated and having had boosters, the authors express some caution in how broad our inferences from their findings should be. Some of those sampled had relatively early forms of the disease, and they were all unvaccinated and older, and died with it, so they clearly do not necessarily fully represent global populations in 2023.

Citation

Tracy, D. K., Albertson, D. N., Sri, A., & Shergill, S. S. (2023). Kaleidoscope - Volume 222 , Issue 3. British Journal of Psychiatry, 222(3), 146-147. https://doi.org/10.1192/bjp.2023.1

• Journal Article Type: Editorial
• Acceptance Date: Feb 14, 2023
• Online Publication Date: Feb 14, 2023
• Publication Date: Mar 1, 2023
• Deposit Date: Jun 21, 2023
• Journal: British Journal of Psychiatry
• Print ISSN: 0007-1250
• Electronic ISSN: 1472-1465
• Publisher: Cambridge University Press (CUP)
• Peer Reviewed: Not Peer Reviewed
• Volume: 222
• Issue: 3
• Pages: 146-147
• DOI: https://doi.org/10.1192/bjp.2023.1
• Public URL: https://uwe-repository.worktribe.com/output/10880980
• Publisher URL: https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/kaleidoscope/4AA4281BEFAAAFA7FC6A8B9EF136FE12