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COVID-19 in an HIV-infected patient. Lessons learned from an autopsy case

Moshawa Calvin Khaba1, Tshepo Cletus Ngale2, Nomandla Madala2

  • 1Department of Anatomical Pathology, Dr George Mukhari Academic Laboratory, National Health Laboratory Services, Sefako Makgatho Health Sciences University, South Africa.

International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases
|September 28, 2020
PubMed

Insights

This autopsy case highlights the first reported death from COVID-19 in an HIV-positive individual. The findings underscore the severe respiratory complications of SARS-CoV-2, even in immunocompromised patients.

Area of Science:

  • Pathology
  • Infectious Diseases
  • Virology

Background:

  • South Africa has experienced significant severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spread, leading to high morbidity and mortality.
  • Autopsies on coronavirus disease 2019 (COVID-19) positive individuals are not standard practice, limiting understanding of the disease's pathological impact.
  • Human immunodeficiency virus (HIV) infection is a significant comorbidity globally, and its interaction with SARS-CoV-2 requires further investigation.

Observation:

  • An autopsy was conducted on a 19-year-old African male with a recent diagnosis of HIV.
  • The patient presented with symptoms consistent with SARS-CoV-2 infection and subsequently tested positive.
  • Histopathological examination revealed significant lung damage, including diffuse alveolar damage and fibrin thrombi.

Findings:

  • The primary cause of death was determined to be COVID-19.
  • No secondary or superimposed infections were identified in the autopsy.
  • Key histopathological findings included diffuse alveolar damage and microvascular fibrin thrombi, indicative of severe COVID-19.

Implications:

  • This case represents the first documented autopsy of an HIV-infected individual where COVID-19 was the confirmed cause of death.
  • The findings emphasize the potential for severe outcomes of SARS-CoV-2 infection in individuals with HIV.
  • Further research into the interplay between HIV and COVID-19 pathogenesis is warranted to inform clinical management and public health strategies.

Keywords:
AutopsyCOVID-19Diffuse alveolar damageFibrin thrombiHuman immunodeficiency virus (HIV)SARS-CoV-2

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