COVID-19 is usually thought of as a respiratory illness. But a detailed autopsy study by researchers at the U.S. National Institutes of Health (NIH) found that the virus can spread throughout the body, including the brain, and that traces of it can remain for months. The findings may help explain some of the lingering symptoms of long COVID.
How the study worked
The team, led by Dr. Daniel Chertow, analyzed tissue samples from complete autopsies of 44 people who died with COVID-19 early in the pandemic. None of them had been vaccinated. For 11 of these patients, the researchers sampled the brain and nervous system extensively. The study was published in Nature.
What the researchers found
- The virus spread widely. Genetic material from SARS-CoV-2, the virus that causes COVID-19, was found throughout the body, in both respiratory and non-respiratory tissues, including the heart, gut and brain.
- It reached the brain early. Viral material was detected in the brain even early in infection.
- It could persist for months. In one patient, viral RNA was still present in multiple tissues, including the brain, about 230 days, or nearly eight months, after symptoms began.
- Little inflammation outside the lungs. Despite the widespread viral material, there was little evidence of inflammation or direct tissue damage outside the respiratory tract.
Dr. Chertow noted that before this work, the prevailing view was that SARS-CoV-2 was mainly a respiratory virus. These results showed it could infect and persist in many organs.
Important context
It’s important to understand what this study does and doesn’t show:
- The patients had severe or fatal COVID-19 and were unvaccinated, so the results may not reflect what happens in people with mild illness or prior vaccination.
- Finding viral RNA doesn’t necessarily mean the virus was still active or infectious. It may reflect fragments of the virus left behind.
- Autopsy studies can show where the virus goes, but not directly how it causes symptoms in living people.
Why it matters for long COVID
Long COVID can cause fatigue, brain fog, shortness of breath, heart rhythm problems and many other symptoms that last for months. One leading theory is that pieces of the virus, or the virus itself, linger in the body and keep the immune system activated. This study adds evidence that the virus can reach and remain in many tissues, supporting that idea. Researchers are now studying living patients to see whether viral persistence is linked to long COVID, and testing whether antiviral treatments might help.
What this means for you
- Lower your risk of severe infection. Staying up to date with recommended vaccines reduces the chance of severe COVID-19, which was the focus of this study.
- Consider early treatment. If you’re at higher risk and test positive, ask about antiviral medicine, which works best when started early.
- Take lingering symptoms seriously. If you still feel unwell weeks after infection, talk with your doctor. Some health systems have dedicated long COVID clinics.
- Pace your recovery. Gradually returning to activity can help avoid setbacks, especially if fatigue worsens after exertion.
- Look after your overall health. Good sleep, nutrition and managing chronic conditions support recovery.
The bottom line
An NIH autopsy study found that the COVID-19 virus spread throughout the body, including the brain, with traces remaining for up to nearly eight months in one case. The findings support research into whether lingering virus contributes to long COVID.
This article is for general information and isn’t medical advice. Talk with your healthcare provider about your individual needs.
