Dr. Choy referenced an interesting article from Stein et al. in which autopsies were conducted on 44 patients who died with COVID-19. With extensive tissue sampling, including the central nervous system, the authors demonstrated that SARS-CoV-2 was widely distributed at time of death, predominantly in patients who passed away from severe COVID-19. The researchers also detected persistent SARS-CoV-2 RNA in multiple organs, including the brain, as late as 230 days after symptom onset in one case. These findings provide a rationale for additional work to define the mechanisms of SARS-CoV-2 persistence that may contribute to post-acute sequelae of the infection.4,5
In Sum
Throughout the presentation, the audience was treated to an extremely helpful summary of the most pressing topics related to COVID-19 in the patients with rheumatologic diseases. COVID-19 is not going anywhere, which is why it remains important to follow the story of this fascinating disease.
Jason Liebowitz, MD, is an assistant professor of medicine in the Division of Rheumatology at Columbia University Vagelos College of Physicians and Surgeons, New York.
References
- Cooksey R, Underwood J, Brophy S, et al. Shielding reduced incidence of COVID-19 in patients with inflammatory arthritis but vulnerability is associated with increased mortality. Rheumatology (Oxford). 2022 Jun 28;61(SI2):SI120–SI128.
- Farisogullari B, Pinto AS, Machado PM. COVID-19-associated arthritis: An emerging new entity? RMD Open. 2022 Sep;8(2):e002026.
- Harris A, Creecy A, Awosanya OD, et al. SARS-CoV-2 and its multifaceted impact on bone health: Mechanisms and clinical evidence. Curr Osteoporos Rep. 2024 Feb;22(1):135–145.
- Zuo Y, Estes SK, Ali RA, et al. Prothrombotic autoantibodies in serum from patients hospitalized with COVID-19. Sci Transl Med. 2020;12(570):eabd3876.
- Stein SR, Ramelli SC, Grazioli A, et al. SARS-CoV-2 infection and persistence in the human body and brain at autopsy. Nature. 2022 Dec;612(7941):758–763.
