Mayo Clinic Laboratory and Pathology Research Roundup: July 13
The research roundup provides an overview of the past week’s research from Mayo Clinic Laboratories consultants, including featured abstracts and a complete list of published studies and reviews.
Neuropathology of COVID-19: a spectrum of vascular and acute disseminated encephalomyelitis (ADEM)-like pathology.
We report the neuropathological findings of a patient who died from complications of COVID-19. The decedent was initially hospitalized for surgical management of underlying coronary artery disease. He developed post-operative complications and was evaluated with chest imaging studies. The chest computed tomography (CT) imaging results were indicative of COVID-19 and he was subsequently tested for SARS-CoV-2, which was positive. His condition worsened and he died after more than 2 weeks of hospitalization and aggressive treatment. The autopsy revealed a range of neuropathological lesions, with features resembling both vascular and demyelinating etiologies. Hemorrhagic white matter lesions were present throughout the cerebral hemispheres with surrounding axonal injury and macrophages. The subcortical white matter had scattered clusters of macrophages, a range of associated axonal injury, and a perivascular acute disseminated encephalomyelitis (ADEM)-like appearance. Additional white matter lesions included focal microscopic areas of necrosis with central loss of white matter and marked axonal injury. Rare neocortical organizing microscopic infarcts were also identified. Imaging and clinical reports have demonstrated central nervous system complications in patients' with COVID-19, but there is a gap in our understanding of the neuropathology. The lesions described in this case provide insight into the potential parainfectious processes affecting COVID-19 patients, which may direct clinical management and ongoing research into the disease. The clinical course of the patient also illustrates that during prolonged hospitalizations neurological complications of COVID may develop, which are particularly difficult to evaluate and appreciate in the critically ill. Via Acta Neuropathologica.
Published to PubMed This Week
- The Heavy Heart of HFpEF.
European Heart Journal
- Augmented Curation of Clinical Notes from a Massive EHR System Reveals Symptoms of Impending COVID-19 Diagnosis.
- Hepatic Focal Nodular Hyperplasia.
Mayo Clinic Proceedings
- Characteristics of Late Transplant-Associated Thrombotic Microangiopathy (TA-TMA) in Patients who Underwent Allogeneic Hematopoietic Stem Cell Transplantation.
American Journal of Hematology
- Biology and Grading of Pleomorphic Xanthoastrocytoma-What Have we Learned About it?
- Treatment of Fibrillary Glomerulonephritis with Rituximab: a 12-Month Pilot Study.
Annals of Surgical Oncology
- Coexisting Systemic and Organ-Specific Autoimmunity in MOG-IgG1-Associated Disorders Versus AQP4-IgG+ NMOSD.
- Histopathologic Assessment of Suspected Idiopathic Pulmonary Fibrosis: Where We Are and Where We Need to Go.
Archives of Pathology Laboratory Medicine
- Next-Generation Sequencing of CYP2C19 in Stent Thrombosis: Implications for Clopidogrel Pharmacogenomics.
Cardiovascular Drugs and Therapy
- Liver Metastases from Pituitary Carcinomas Mimicking Visceral Well-Differentiated Neuroendocrine Tumors: A Series of Four Cases.
- Open-Label Prospective Therapeutic Clinical Trials: Oral Vancomycin in Children and Adults with Primary Sclerosing Cholangitis.
Scandinavian Journal of Gastroenterology
- Quantification of Serum Sulfamethoxazole and Trimethoprim by Ultra-Fast SPE-MS/MS.
Therapeutic Drug Monitoring
- Pilot Study of a New Online Extracorporeal Photopheresis System in Patients with Steroid Refractory or Dependent Chronic Graft vs Host Disease.
Journal of Clinical Apheresis
- Epidemiological Trends in the Timing of In-Hospital Death in Acute Myocardial Infarction-Cardiogenic Shock in the United States.
Journal of Clinical Medicine
- Long-Term Outcomes of Incidental Prostate Cancer at Radical Cystectomy.
Urology and Oncology