Emerging spectrum of COVID-19-related cardiopulmonary pathology in adults

Area of Science:

• Pathology
• Histopathology
• Infectious Diseases

Background:

• Coronavirus disease 2019 (COVID-19) is a significant global health concern, causing widespread morbidity and mortality.
• Histopathologists frequently encounter COVID-19 cases, necessitating an understanding of its pathological manifestations.
• While COVID-19 affects multiple organ systems, the lungs and heart are primary sites of significant pathology.

Purpose of the Study:

• To provide general histopathologists with key pathological findings in the lungs and heart of adult COVID-19 patients.
• To emphasize the importance of clinicopathological correlation by discussing cardiopulmonary clinical features alongside pathological findings.
• To review techniques for identifying the SARS-CoV-2 virus in fixed tissues, noting limitations specific to cardiac and pulmonary samples.

Main Methods:

• Review of histopathological findings in lung and heart tissues from adult COVID-19 patients.
• Correlation of clinical features with observed pathological changes.
• Evaluation of methods for viral detection in formalin-fixed, paraffin-embedded tissues.

Main Results:

• Diffuse alveolar damage is a prominent finding in lung pathology, exhibiting diverse morphological changes over time.
• Cardiac pathology, though less extensive than pulmonary, is also a significant consideration in COVID-19.
• Clinicopathological correlation is crucial for accurate diagnosis and understanding disease progression.
• Various techniques exist for viral identification, but their efficacy can be influenced by tissue fixation and specific organ context.

Conclusions:

• Understanding the spectrum of lung and heart pathology in COVID-19 is essential for practicing histopathologists.
• Clinicopathological correlation enhances diagnostic accuracy and patient management.
• Knowledge of viral detection methods and their limitations aids in confirming infection in tissue samples.