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Neuropathological Features of COVID-19

In This Video

  • Full-body and brain autopsies of individuals that passed away from COVID-19 had very little to minimal neuro-inflammation
  • These patients had very low levels of viral RNA for SARS as shown by PCR in multiple brain regions
  • There is minimal pathology that is associated with this viral presence in the brain of patients that have passed away as a result of COVID-19

Shibani S. Mukerji, MD, PhD, associate director of the Neuro-Infectious Diseases Unit of the Department of Neurology at Massachusetts General Hospital, discusses the neuropathological features of COVID-19. In this video, Dr. Mukerji details the impact the virus has on the brain, showing that there is minimal viral presence.


Neuropathological features of COVID-19: Our work was really in a wonderful collaboration with Isaac Solomon at the Brigham. We were able to do autopsy studies both for full-body as well as brain, and in brain studies, we looked at individuals that had consecutively passed away from COVID-19. So these are individuals that did not necessarily have neurological manifestations but had died from largely respiratory complications. These individuals all had 100% hypoxic-ischemic injury that you could identify in the brain.

What was interesting and unique a little bit about COVID-19, and it's different than what we see many times in other neuroinvasive viruses, is that patients with COVID-19 had very little to minimal neuro-inflammation—so inflammatory cells that were inside the brain space. We were able to identify, with collaboration with Pardis Sabeti at the Broad, very low levels of viral RNA for SARS. This was done by quantitative PCR and we looked at multiple different sections of the brain. This study was the one that was published in the New England Journal of Medicine.

Most studies are not able to identify protein or an infected cell with the exception of one study that did identify some of the cranial nerves infected with SARS and there are some scattering cells in the brain stem that do have SARS immunohistochemical positivity. What was interesting about this study that correlates with the study that we published in the New England Journal is essentially, there's really minimal pathology that seems to be associated at least with this viral presence.

Other work that will be continuing on is to also look, with collaboration with Bruce Fischl at the Martinos Center as well as Brian Edlow here at Mass General, is how we use imaging, so MR imaging, at an ultrahigh resolution to target our histopathological diagnostics.

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