众所周知，冠状病毒病 2019（新冠肺炎）在严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）急性感染期间会导致多器官功能障碍，一些患者出现长期症状，称为SARS-CoV 2急性后遗症。然而，呼吸系统之外的器官感染的负担和病毒清除的时间尚不明确，特别是在大脑中。在这里，我们对44名死于新冠肺炎的患者进行了完整的尸检，其中11名患者的中枢神经系统进行了广泛采样，以绘制和量化从急性感染到症状出现7个多月后，SARS-CoV-2在包括大脑在内的整个人体内的分布、复制和细胞型特异性。我们发现SARS-CoV-2是广泛分布的，尤其是在死于严重新冠肺炎的患者中，病毒复制存在于感染早期的多个呼吸道和非呼吸道组织中，包括大脑。此外，我们在多个解剖部位（包括整个大脑）检测到持续存在的SARS-CoV-2 RNA，最迟在一例患者出现症状后230天。尽管SARS-CoV-2 RNA在全身广泛分布，但我们几乎没有观察到呼吸道之外的炎症或直接病毒细胞病理学的证据。我们的数据表明，在某些患者中，SARS-CoV-2可导致全身感染，并在体内持续数月。

英文摘要

Coronavirus disease 2019 (COVID-19) is known to cause multi-organ dysfunction during acute infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with some patients experiencing prolonged symptoms, termed post-acute sequelae of SARS-CoV-2. However, the burden of infection outside the respiratory tract and time to viral clearance are not well characterized, particularly in the brain. Here we carried out complete autopsies on 44 patients who died with COVID-19, with extensive sampling of the central nervous system in 11 of these patients, to map and quantify the distribution, replication and cell-type specificity of SARS-CoV-2 across the human body, including the brain, from acute infection to more than seven months following symptom onset. We show that SARS-CoV-2 is widely distributed, predominantly among patients who died with severe COVID-19, and that virus replication is present in multiple respiratory and non-respiratory tissues, including the brain, early in infection. Further, we detected persistent SARS-CoV-2 RNA in multiple anatomic sites, including throughout the brain, as late as 230 days following symptom onset in one case. Despite extensive distribution of SARS-CoV-2 RNA throughout the body, we observed little evidence of inflammation or direct viral cytopathology outside the respiratory tract. Our data indicate that in some patients SARS-CoV-2 can cause systemic infection and persist in the body for months.

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