COVID-19 autopsies yield clues for researchers

Sophisticated molecular tools are helping pathologists uncover new avenues for COVID-19 research during autopsies of patients who died from the disease.

“By comparing the molecular signatures of infected and uninfected tissues, we were able to identify four major …. pathways driving severe COVID-19,” said Elisabet Pujadas of the Icahn School of Medicine at Mount Sinai in New York City.

Those pathways involve blood vessels, cell-signaling proteins called cytokines, and cell activation, structure and degradation, she and her colleagues explained in a report published on Wednesday in The American Journal of Pathology.

“Specific genes within those pathways can help explain why we see excessive inflammation and clotting and thus constitute exciting targets for potential new therapies that are aimed directly at the core of the problem,” Pujadas said.

The research also found that while the coronavirus is known to use a cell surface protein called ACE2 as a “receptor,” or gateway, patients’ brains have high levels of other gateway proteins the virus could potentially use, called BSg and ANPEP.

“While this does not by itself demonstrate that infection is occurring through these receptors, it demands that we think and study these receptors more broadly and not assume that ACE2 alone conveys the full picture,” Pujadas said.