Gross and Histopathology of COVID-19 With First Histology Report of Olfactory Bulb Changes

George S Stoyanov; Lilyana Petkova; Deyan L Dzhenkov; Nikolay R Sapundzhiev; Iliyan Todorov

doi:10.7759/cureus.11912

Gross and Histopathology of COVID-19 With First Histology Report of Olfactory Bulb Changes

Cureus. 2020 Dec 4;12(12):e11912. doi: 10.7759/cureus.11912.

Authors

George S Stoyanov¹, Lilyana Petkova¹, Deyan L Dzhenkov¹, Nikolay R Sapundzhiev², Iliyan Todorov³

Affiliations

¹ General and Clinical Pathology/Forensic Medicine and Deontology, Medical University of Varna, Varna, BGR.
² Otolaryngology, Medical University of Varna, Varna, BGR.
³ Infectious Diseases, Parasitology and Dermatovenerology, Medical University of Varna, Varna, BGR.

Abstract

In nearly a year since the first reported cases of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a lot has been established about the virus. Correlates in regards to the biology and cellular effects of SARS-CoV-2 have brought a lot of explanations to the clinical manifestations of the disease and possible therapeutic modalities. However, despite the discoveries made, the tropism of SARS-CoV-2 has not yet been fully established, nor have all the clinical aspects of COVID-19. Herein we report the gross and histological findings in two diseased patients. Apart from the already established pulmonary and vascular changes caused by SARS-CoV-2, we report the presence of histological changes of the olfactory bulbs and frontal lobes of the brain, which may present as a correlate for COVID-19 related anosmia. The olfactory bulbs histologically showed necrotizing olfactory bulbitis. As both the olfactory bulb and frontal lobe of the cerebrum are key areas of olfaction, we believe that this tropism of SARS-CoV-2 may be key to the development of anosmia and not changes within the nasal cavity.

Keywords: anosmia; autopsy; covid-19; olfactory bulbitis; pathology; pneumonia.

Publication types

Case Reports