SARS-CoV-2 Spike Protein in Intestinal Cells of a Patient with Coronavirus Disease 2019 Multisystem Inflammatory Syndrome

Post-acute sequelae of COVID-19: A metabolic perspective

“…Some clues from a case study suggest that in at least a subset of patients, the extrapulmonary burden of SARS-CoV-2 may be attributed to a substantial fraction of the virus found in the body ( Li et al, 2021 ). In addition, a case report from an autopsy of a young individual acutely infected with SARS-CoV-2 detected the presence of spike protein in intestinal cells ( Mayordomo-Colunga et al, 2021 ). Similarly, it is established that the virus can be detected in feces, and possibly spread through fecal contamination ( Moura et al, 2022 ), although there are no data yet as to whether there is persistent viral shedding in long-COVID patients.…”

Multisystem inflammatory syndrome in children (MIS-C) showing disseminated aspergillosis, cytomegalovirus reactivation and persistent SARS-COV-2: Case report with autopsy review

“…Coronaviruses are known to be able to block interferon responses and it has been proposed that MIS-C might then result from delayed cytokine storm in patients who do not control viral replication well or suffered an initially high SARS-CoV-2 viral load [33] . Of note, virus has been demonstrated in 100 % of autopsies reported to date (including our case) and involving organs related to the cause of death [13] , [15] . This finding suggests that the pathogenesis of MIS-C may not be so straightforward as a post-infectious event.…”

“…Unfortunately, there are very few autopsy studies on MIS-C reported to date, to which we can compare our finding. Four cases are from South America and a fifth from Spain [12] , [13] , [14] , [15] . Ages ranged from 8 to 12 years except one case at 10 months.…”

“…Autopsy examination can play a particularly important role in helping to define and understand MIS-C. Yet, very few autopsy studies have been reported to date, comprising five cases to date, originating from Brazil, Columbia and Spain [12] , [13] , [14] , [15] .…”

Advances in understanding Kawasaki disease‐related immuno‐inflammatory response and vascular endothelial dysfunction

“… 60 During autopsy analysis of a previously healthy patient who died of MIS‐C, SARS‐CoV‐2 spike protein was found in intestinal cells, indicating that SARS‐CoV‐2 in the intestine may contribute to the MIS‐C‐related immune response. 62 Activation of type 1 dendritic cells and imbalance of NK cells, coordinated by complex cytokine signaling, have been suggested as key pathophysiological features of MIS‐C; these may promote antigenic cross‐talk and macrophage activation syndrome, respectively. 63 Most autoreactive peptides in patients with MIS‐C are characterized by enrichment in central organs, which differs from such peptides in patients with KD.…”