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Published on: December 19, 2020
Pathological Features in 100 Deceased Patients With COVID-19 in Correlation With Clinical and Laboratory Data
L M Mikhaleva1, A L Cherniaev1, M V Samsonova1
1Research Institute of Human Morphology, Moscow, Russia.
Insights
Autopsies reveal widespread coagulopathy and diffuse alveolar damage as key factors in COVID-19 mortality. Extrapulmonary effects on the liver and spleen are also significant in understanding fatal outcomes from SARS-CoV-2 infection.
Area of Science:
- Pathology
- Infectious Diseases
- Forensic Medicine
Background:
- COVID-19 autopsies face limitations due to safety measures.
- Clinical data may not align with post-mortem findings.
- Understanding COVID-19 mortality mechanisms is crucial.
Purpose of the Study:
- Identify pathognomonic factors in COVID-19 mortality.
- Correlate clinical and autopsy findings.
- Analyze 100 full-body autopsies of COVID-19 deceased patients.
Main Methods:
- Conducted 100 full-body autopsies following safety protocols.
- Evaluated macroscopic and microscopic pathologies.
- Assessed clinical and laboratory findings.
Main Results:
- Widespread coagulopathic changes observed.
- Diffuse alveolar damage is pathognomonic for COVID-19 pneumonia, especially in younger patients.
- Extrapulmonary pathology affects liver and spleen; intravascular thrombosis and septic shock are common.
Conclusions:
- Pathological findings offer insight into SARS-CoV-2 lethality.
- COVID-19 severity may be influenced by genetic or epigenetic factors.
- No obvious bias in severity, but individual variability exists.
Abstract:
Background: Autopsies on COVID-19 deceased patients have many limitations due to necessary epidemiologic and preventative measures. The ongoing pandemic has caused a significant strain on healthcare systems and is being extensively studied around the world. Clinical data does not always corelate with post-mortem findings. The goal of our study was to find pathognomonic factors associated with COVID-19 mortality in 100 post-mortem full body autopsies. Materials and Methods: Following necessary safety protocol, we performed 100 autopsies on patients who were diagnosed with COVID-19 related death. The macroscopic and microscopic pathologies were evaluated along with clinical and laboratory findings. Results: Extensive coagulopathic changes are seen throughout the bodies of diseased patients. Diffuse alveolar damage is pathognomonic of COVID-19 viral pneumonia, and is the leading cause of lethal outcome in younger patients. Extrapulmonary pathology is predominantly seen in the liver and spleen. Intravascular thrombosis is often widespread and signs of septic shock are often present. Conclusion: The described pathological manifestations of COVID-19 in deceased patients are an insight into the main mechanisms of SARS-CoV-2 associated lethal outcome. The disease bears no obvious bias in severity, but seems to be more severe in some patients, hinting at genetic or epigenetic factors at play.
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