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Cardiac pathology in COVID-19: a single center autopsy experience

Charlie J Sang1, Alison Burkett2, Brittain Heindl3

  • 1Department of Internal Medicine and Pediatrics, University of Alabama at Birmingham, Birmingham, AL.

Cardiovascular Pathology : the Official Journal of the Society for Cardiovascular Pathology
|July 17, 2021
PubMed

Insights

Autopsies of 50 patients who died from COVID-19 revealed common cardiac findings like fibrosis and hypertrophy, not widespread inflammation. The exact cause of myocardial injury in COVID-19 remains unclear, warranting further research.

Area of Science:

  • Pathology
  • Cardiology
  • Infectious Diseases

Background:

  • Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is linked to myocardial injury and heart failure.
  • The precise mechanisms driving cardiac complications in COVID-19 are not fully understood.
  • This study details cardiac findings from autopsies of 50 patients deceased from COVID-19.

Purpose of the Study:

  • To investigate the cardiac pathology in patients who died from COVID-19.
  • To identify common cardiovascular comorbidities and their association with COVID-19 related cardiac injury.
  • To explore potential pathophysiological mechanisms of myocardial injury in COVID-19.

Main Methods:

  • Autopsies were performed on 50 patients with confirmed SARS-CoV-2 infection.
  • Both macroscopic and microscopic examinations were conducted following a COVID-19 safety protocol.
  • Available laboratory findings and echocardiograms were reviewed.

Main Results:

  • The most frequent comorbidities were hypertension (90.0%), diabetes (56.0%), and obesity (50.0%).
  • Common findings included myocardial fibrosis (80.0%), hypertrophy (72.0%), and microthrombi (66.0%).
  • Lymphocytic infiltrates and myocarditis were infrequent (16.0% and 4.0% respectively).

Conclusions:

  • Prevalent cardiovascular comorbidities and changes of hypertensive/atherosclerotic disease were noted.
  • Despite elevated inflammatory markers, direct inflammatory cardiac cell damage was rare.
  • A definitive pathophysiological link for COVID-19-induced myocardial injury is still undetermined, necessitating further investigation.
Abstract

Keywords:
Cardiac pathologyCardiovascular diseaseCoronavirus disease 2019Severe acute respiratory syndrome coronavirus 2

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