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Pathological Findings Associated With SARS-CoV-2 on Postmortem Core Biopsies: Correlation With Clinical Presentation

Jose-Manuel Ramos-Rincon1,2, Cristian Herrera-García1, Sandra Silva-Ortega3

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Frontiers in Medicine
|July 25, 2022
PubMed
Summary

Needle core necropsies reveal that proliferative diffuse alveolar damage (DAD) was common in lungs of COVID-19 patients, linked to longer disease duration. Heart and liver changes were also frequently observed in these cases.

Keywords:
COVID-19SARS-CoV-2autopsycoronaviruspathology

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Area of Science:

  • Pathology
  • Infectious Diseases
  • Pulmonology

Background:

  • Autopsies are crucial for understanding the pathogenesis of emerging diseases like COVID-19.
  • Needle core necropsy provides minimally invasive tissue samples for histopathological analysis.

Purpose of the Study:

  • To document the histopathological findings in the lungs, heart, and liver of individuals who died from COVID-19 using needle core necropsy.
  • To correlate specific pathological findings with clinical data and disease course.

Main Methods:

  • A cross-sectional study involving needle core necropsies on 71 patients with confirmed COVID-19.
  • Histopathological examination of lung, heart, and liver tissues.
  • Correlation of findings with clinical data, including lactate dehydrogenase levels and tocilizumab treatment.

Main Results:

  • Diffuse alveolar damage (DAD) was prevalent in lung samples (82.3%), with proliferative DAD being a significant finding.
  • Proliferative DAD was associated with a longer disease course (onset-to-death interval >15 days) and elevated lactate dehydrogenase.
  • Abnormalities in the heart (47.9%) included fiber hypertrophy and fibrosis, while liver changes (74.4%) comprised steatosis, cholestasis, and necrosis.

Conclusions:

  • Proliferative DAD is a key lung finding in COVID-19 fatalities, associated with prolonged illness.
  • Needle core necropsy is effective in characterizing organ damage in COVID-19.
  • Significant cardiac and hepatic pathology frequently accompanies fatal COVID-19 infections.