A 42-year-old man was admitted to the intensive care unit in October 2020 for coronavirus disease-19 (COVID-19)-related acute respiratory distress syndrome requiring mechanical ventilation. He presented with multi-organ failure and died 41 days later. Comorbidities included a sleeve gastrectomy in 2016 and cholecystectomy in April 2020.
Autopsy revealed diffuse alveolar damage (Fig. 1A) and presence of severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) in the carotid body (Fig. 1B, C). Detection of SARS-CoV-2 in the carotid body was performed by real-time reverse transcription polymerase chain reaction (Fig. 1D).
The carotid body plays a role in peripheral arterial chemoreception, in metabolic and immune sensing, and could also be a route of nervous system invasion by SARS-CoV-2. Involvement of the carotid body by SARS-CoV-2 may explain silent hypoxemia and thus could also contribute to increased morbidity and mortality in COVID-19 patients.
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Lambermont, B., Davenne, E., Maclot, F. et al. SARS-CoV-2 in carotid body. Intensive Care Med (2021). https://doi.org/10.1007/s00134-021-06351-z