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Published on: December 19, 2020
Pathological Changes and Cause of Death Associated with the Global Novel Coronavirus Disease (COVID-19)
Bin Yang1, Lu-Yao Xu1, Ling-Yue Li1
1Department of Forensic Pathology, School of Forensic Medicine, Southern Medical University, Forensic Science Center of Southern Medical University, Guangzhou 510515, China.
Insights
Coronavirus disease 2019 (COVID-19) causes severe lung damage and multi-organ failure, leading to death. Autopsy reviews confirm life-threatening pathological changes in vital organs from SARS-CoV-2 infection.
Area of Science:
- Pathology
- Infectious Diseases
- Pulmonology
Background:
- The global COVID-19 pandemic has caused millions of deaths, characterized by high infectivity and multi-system damage, primarily affecting the lungs.
- Despite extensive research, consensus on the specific pathological changes and definitive causes of death in COVID-19 fatalities remains elusive.
- Understanding the disease's pathology is crucial for advancing clinical treatment and developing effective therapeutics.
Approach:
- A comprehensive review of autopsy reports and global literature published between February 2020 and June 2023 was conducted.
- Inclusion criteria focused on studies with a defined number of autopsy cases and documented pathological changes in vital organs.
- Data from 1,111 autopsy cases across 65 papers from 18 countries were analyzed.
Key Points:
- Analysis revealed common pathological changes associated with COVID-19 infection across diverse populations.
- Statistical classification of pathological manifestations and causes of death provided insights into disease progression.
- Severe lung damage was identified as a primary contributor to mortality, often leading to secondary organ failure.
Conclusions:
- COVID-19 infection can induce severe, life-threatening pathological alterations in critical organs.
- The direct cause of death is predominantly severe lung damage, compounded by systemic multiple organ failure.
- Findings underscore the critical role of pulmonary pathology and subsequent organ dysfunction in COVID-19 mortality.
Abstract:
The coronavirus disease 2019 (COVID-19) has been a global epidemic for more than three years, causing more than 6.9 million deaths. COVID-19 has the clinical characteristics of strong infectivity and long incubation period, and can cause multi-system damage, mainly lung damage, clinical symptoms of acute respiratory distress syndrome (ARDS) and systemic multiple organ damage. The SARS-CoV-2 virus is still constantly mutating. At present, there is no global consensus on the pathological changes of COVID-19 associated deaths and even no consensus on the criteria for determining the cause of death. The investigation of the basic pathological changes and progression of the disease is helpful to guide the clinical treatment and the development of therapeutic drugs. This paper reviews the autopsy reports and related literature published worldwide from February 2020 to June 2023, with a clear number of autopsy cases and corresponding pathological changes of vital organs as the inclusion criteria. A total of 1 111 autopsy cases from 65 papers in 18 countries are included. Pathological manifestations and causes of death are classified and statistically analyzed, common pathological changes of COVID-19 are summarized, and analytical conclusions are drawn, suggesting that COVID-19 infection can cause life-threatening pathological changes in vital organs. On the basis of different health levels of infected groups, the direct cause of death is mainly severe lung damage and secondary systemic multiple organ failure.
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