Analysis of the blood-brain barrier at the transmission electron microscope at the Institute for Neuropathology. Photo: JLU / Wegst
TO WATER (red). Sars-Cov-2 infections appear to affect organs other than the lungs. “There are indications of heart and kidney infections in Covid 19, but also evidence of central nervous system involvement,” says Prof. Till Acker, head of the Institute for Neuropathology at the Justus Liebig University (JLU) and chairman of the board German Society for Neuropathology and Neuroanatomy (DGNN). So far, however, there is no reliable evidence that nerve cells are affected by the novel coronavirus or that neurons are invaded by Sars CoV-2. It has already been detected for infections with other human coronaviruses. In order to investigate a possible involvement of the nervous system in Covid-19, on the initiative of the DGNN a nationwide register with human samples from the central and peripheral nervous system (CNS, PNS) in Covid-19 autopsies is being set up. The CNS-Covid-19 registry is organized by the Institute for Neuropathology and the Institute for Medical Informatics of the JLU together with the Miracum Consortium (Medical Informatics in Research and Care in University Medicine). “Miracum” is funded as part of the Medical Informatics Initiative (MI-I) by the Federal Ministry of Education and Research (BMBF); All three member universities of the Mittelhessen research campus are members, according to a JLU press release.
Dizziness and headache
“It is being discussed whether involvement of the central nervous system due to a disruption of the cardiorespiratory centers in the brain stem is partly responsible for the often unfavorable course of the disease in Covid-19 patients, even under ventilation,” said Till Acker. Many people who develop Covid-19 suffer in particular from dizziness, headache and severe impairment of their sense of smell and taste. A study from Wuhan (China) showed neurological symptoms in a third of the patients with Covid19. In addition, the genetic material of Sars-CoV-2 has been detected in the brain-spinal cord fluid, it is said.
With the new biobank, the basis should now be created to characterize a possible CNS involvement in detail morphologically, molecularly and clinically and to better understand the pathomechanisms of the Sars-CoV-2 infection. It is not known in which clinical courses and in what frequency the CNS is involved in Covid-19. In addition, a close collaboration has been agreed with the PanN3 initiative of the German Neurological Society (DGN), which examines neurological comorbidities in Covid-19.
The registry is to be networked with other Covid 19 patient registries for confederate queries using the platforms developed by the Medical Informatics Initiative. “There will be a close exchange with other specialist societies,” emphasizes Acker. “The registry will be made available to the scientific community.” The DGNN has applied for the facility as part of the “National Research Network for University Medicine on Covid-19” coordinated by the Charité – Universitätsmedizin Berlin.
Prepare for the future
In addition to Till Acker, Prof. Henning Schneider (Medical Informatics) and Prof. Keywan Sohrabi (Technical University of Central Hesse), Privatdozent Dr. Jan de Laf Folie (pediatrics), private lecturer Dr. Anne Schänzer (neuropathology) and Prof. Christiane Herden (veterinary pathology). Prof. Axel Pagenstecher (Neuropathology) from the Philipps University of Marburg also belongs to the team. A quick implementation of the project is made possible, among other things, by using the existing Cedata-GPGE register for children and adolescents with chronic inflammatory bowel diseases, which is managed by Jan de Laf Folie. “Research into complex diseases requires the integration of data beyond the individual locations in Germany,” says de Laf Folie. “With our expertise in longitudinal, multicentre data acquisition and archiving, the register for Covid-19 can be set up within a very short time and we can adequately prepare ourselves for future challenges.”
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