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Common pathological findings in the heart in COVID-19-related sudden death cases: An autopsy case series

Daisuke Kyuno1, Masatoshi Tateno2, Yusuke Ono1

  • 1Department of Pathology, Sapporo Medical University, Sapporo, Japan.

Heliyon
|October 16, 2023
PubMed

Insights

Sudden cardiac death after COVID-19 infection or vaccination may be linked to cardiomyopathy. Autopsy revealed characteristic microscopic changes in the heart, aiding diagnosis when standard methods are inconclusive.

Area of Science:

  • Cardiovascular Pathology
  • Infectious Disease Pathology
  • Forensic Pathology

Background:

  • Cardiomyopathy is a significant cause of sudden death following SARS-CoV-2 infection and COVID-19 vaccination.
  • Diagnosing these unexpected cardiomyopathies can be difficult due to a lack of distinct pathological findings.

Observation:

  • Autopsy of two sudden death cases (one post-infection, one post-vaccination) revealed common cardiac pathology.
  • Key findings included decreased staining intensity, loss of rhabdomeres, and cardiomyocyte multivacuolation without inflammation.

Findings:

  • Specific microscopic cardiac alterations were identified in both cases of sudden death.
  • These findings were consistently observed despite different triggers (infection vs. vaccination).

Implications:

  • Decreased staining intensity with special stains may help diagnose COVID-19-related cardiomyopathy in sudden death cases.
  • This diagnostic aid is valuable even when Hematoxylin and Eosin (H&E) staining shows minimal abnormalities.
Abstract

Keywords:
Autopsy case seriesCoronavirus disease 2019Sudden deathVaccinationcardiomyopathy

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