Postmortem Findings Associated With SARS-CoV-2: Systematic Review and Meta-analysis.

Area of Science:

• Pathology
• Virology
• Public Health

Background:

• Coronavirus Disease 2019 (COVID-19), caused by SARS-CoV-2, is a significant global health concern.
• COVID-19 exhibits higher pathogenicity and infectivity than the earlier SARS-CoV-1.
• The precise mechanisms behind COVID-19 mortality are not fully understood.

Purpose of the Study:

• To systematically review and summarize the emerging literature on COVID-19 autopsies.
• To compare postmortem findings in COVID-19 with those from SARS-CoV-1 deaths through meta-analysis.

Main Methods:

• Systematic literature review of COVID-19 autopsies.
• Meta-analysis comparing data from 241 COVID-19 patients with 91 SARS-CoV-1 patients.
• Analysis of autopsy findings including diffuse alveolar damage and extrapulmonary manifestations.

Main Results:

• Diffuse alveolar damage was less prevalent in COVID-19 (80.9%) compared to SARS-CoV-1 (100.0%) autopsies.
• Hepatic necrosis, splenic necrosis, and white pulp depletion were more common in SARS-CoV-1 deaths.
• COVID-19 autopsies revealed pulmonary hemorrhage, viral cytopathic effects, thromboembolism, brain infarction, endotheliitis, renal tubular damage, splenic white pulp depletion, cardiac myocyte necrosis, megakaryocyte recruitment, and hemophagocytosis.

Conclusions:

• While sharing some pathological similarities, COVID-19 and SARS-CoV-1 exhibit distinct postmortem findings.
• Key differences in organ damage prevalence and specific manifestations were observed between the two viral infections.
• Further research into COVID-19 pathogenesis is warranted based on autopsy findings.