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Postmortem Biopsies of the Lung, Heart, Liver, and Spleen of COVID-19 Patients
Isil Yurdaisik1, Ahu S Demiroz2, Aysim B Oz2
1Radiology, Istinye University Medical Park Gaziosmanpasa Hospital, Istanbul, TUR.
Insights
Postmortem core needle biopsies revealed significant histopathologic alterations in the lungs, heart, liver, and spleen of coronavirus disease 2019 (COVID-19) decedents. This minimally invasive technique proved feasible for examining COVID-19-related tissue damage.
Area of Science:
- Pathology
- Virology
- Medical Imaging
Background:
- Coronavirus disease 2019 (COVID-19) has caused a global pandemic, necessitating detailed understanding of its pathological effects.
- Postmortem examination is crucial for elucidating organ-specific damage caused by severe infections.
- Previous autopsy studies provide foundational knowledge, but minimally invasive techniques require evaluation.
Purpose of the Study:
- To assess the histopathologic alterations in the lungs, heart, liver, and spleen of COVID-19 decedents.
- To evaluate the feasibility and adequacy of postmortem core needle biopsies for histopathological examination.
- To correlate radiological findings with histopathological results in COVID-19 cases.
Main Methods:
- A postmortem case series involving patients who died from confirmed COVID-19.
- Ultrasound-guided percutaneous core needle biopsies of the lungs, heart, liver, and spleen using 14- and 16-gauge needles.
- Hematoxylin-eosin staining and light microscopy for histopathological analysis; collection of clinicodemographic data, chest CT images, and treatment information.
Main Results:
- Lung biopsies demonstrated diffuse alveolar damage in all examined specimens.
- Liver biopsies showed patchy necrosis, steatosis, and mononuclear cell infiltration.
- Splenic examination revealed common findings of necrosis and neutrophil infiltration; heart findings were nonspecific.
- Chest CT predominantly showed bibasilar ground-glass opacities, correlating with lung histopathology.
Conclusions:
- Postmortem core needle biopsy is a feasible and adequate method for histopathological examination of multiple organs in COVID-19 decedents.
- Histopathological findings in biopsied tissues align with previous autopsy studies and radiological observations.
- This technique offers a valuable alternative for studying the organ-specific pathology of COVID-19.
Abstract:
Objective We aimed to evaluate histopathologic alterations in the lung, heart, liver, and spleen of coronavirus disease 2019 (COVID-19) decedents through postmortem core needle biopsies. Materials and methods Patients who died of reverse transcription-polymerase chain reaction-proven COVID-19 were included in this postmortem case series. Postmortem percutaneous ultrasound-guided biopsies of the lungs, heart, liver, and spleen were performed using 14- and 16-gauge needles. Biopsy samples were stained with hematoxylin-eosin and examined under a light microscope. Clinicodemographic characteristics, chest computed tomography (CT) images, and COVID-19-related treatments of the patients were also collected. Results Seven patients were included in this study. Liver and heart tissue samples were available from all patients, and lung and spleen tissue samples were available from five and three patients, respectively. Chest CT images predominantly revealed bibasilar ground-glass opacities. Lung biopsies showed diffuse alveolar damage in all biopsy specimens. Heart findings were nonspecific and largely compatible with the underlying disease. Patchy necrosis, steatosis, and mononuclear cell infiltration were the main findings in the liver biopsies. Splenic histopathological examination showed that splenic necrosis and neutrophil infiltration were common findings in all patients. Conclusion Tissue acquisition was complete for the heart and liver and acceptable for the lungs. The amount of tissue was sufficient for a proper histopathologic examination. Histopathological findings were generally in accordance with previous autopsy studies. Radiological findings of the lung were also correlated with the histopathologic findings. We consider that a postmortem biopsy is a feasible alternative for histopathological examinations in COVID-19 decedents.
