New Mexico's COVID-19 Experience

Area of Science:

• Pathology
• Infectious Diseases
• Public Health

Background:

• COVID-19 has caused a global pandemic, impacting diverse populations.
• Existing literature often relies on clinical data or hospital autopsies, potentially confounding pathology.
• Limited infection rates and high biosafety allowed for comprehensive autopsies in New Mexico.

Purpose of the Study:

• To investigate the pure pathological findings of COVID-19 deaths.
• To characterize the demographic and comorbidity profile of decedents.
• To identify common pathological features in severe acute respiratory syndrome coronavirus 2 fatalities.

Main Methods:

• Full autopsy examinations were performed on 20 severe acute respiratory syndrome coronavirus 2-positive decedents.
• Demographic data, comorbidities, and macroscopic findings were systematically recorded.
• Histopathological analysis focused on lung tissue to assess diffuse alveolar damage.

Main Results:

• Diffuse alveolar damage was present to some extent in all COVID-19 deaths.
• The average decedent was middle-aged, male, American Indian, overweight, with diabetes, ethanolism, and cardiovascular disease.
• Macroscopic thrombotic events (pulmonary thromboemboli, coronary artery thrombi) occurred in 35% of cases; 2 cases had bacterial coinfections.

Conclusions:

• Diffuse alveolar damage is a consistent finding in COVID-19 related deaths.
• Specific demographic and comorbidity profiles are associated with severe outcomes.
• Thrombotic events and coinfections are significant complications in fatal COVID-19 cases.