Pathological Findings Associated With SARS-CoV-2 on Postmortem Core Biopsies : Correlation With Clinical Presentation and Disease Course
Copyright © 2022 Ramos-Rincon, Herrera-García, Silva-Ortega, Portilla-Tamarit, Alenda, Jaime-Sanchez, Arenas-Jiménez, Fornés-Riera, Scholz, Escribano, Pedrero-Castillo, Muñoz-Miguelsanz, Orts-Llinares, Martí-Pastor, Amo-Lozano, García-Sevila, Ribes-Mengual, Moreno-Perez, Concepcion-Aramendía, Merino, Sánchez-Martínez and Aranda..
Background: Autopsies can shed light on the pathogenesis of new and emerging diseases.
Aim: To describe needle core necropsy findings of the lung, heart, and liver in decedents with COVID-19.
Material: Cross-sectional study of needle core necropsies in patients who died with virologically confirmed COVID-19. Histopathological analyses were performed, and clinical data and patient course evaluated.
Results: Chest core necropsies were performed in 71 decedents with a median age of 81 years (range 52-97); 47 (65.3%) were men. The median interval from symptoms onset to death was 17.5 days (range 1-84). Samples of lung (n = 62, 87.3%), heart (n = 48, 67.6%) and liver (n = 39, 54.9%) were obtained. Fifty-one lung samples (82.3%) were abnormal: 19 (30.6%) showed proliferative diffuse alveolar damage (DAD), 12 (19.4%) presented exudative DAD, and 10 (16.1%) exhibited proliferative plus exudative DAD. Of the 46 lung samples tested for SARS-CoV-19 by RT-PCR, 39 (84.8%) were positive. DAD was associated with premortem values of lactate dehydrogenase of 400 U/L or higher [adjusted odds ratio (AOR) 21.73; 95% confidence interval (CI) 3.22-146] and treatment with tocilizumab (AOR 6.91; 95% CI 1.14-41.7). Proliferative DAD was associated with an onset-to-death interval of over 15 days (AOR 7.85, 95% CI 1.29-47.80). Twenty-three of the 48 (47.9%) heart samples were abnormal: all showed fiber hypertrophy, while 9 (18.8%) presented fibrosis. Of the liver samples, 29/39 (74.4%) were abnormal, due to steatosis (n = 12, 30.8%), cholestasis (n = 6, 15.4%) and lobular central necrosis (n = 5, 12.8%).
Conclusion: Proliferative DAD was the main finding on lung core needle necropsy in people who died from COVID-19; this finding was related to a longer disease course. Changes in the liver and heart were common.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:9 |
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| Enthalten in: |
Frontiers in medicine - 9(2022) vom: 05., Seite 874307 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Ramos-Rincon, Jose-Manuel [VerfasserIn] |
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| Links: |
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| Themen: |
Autopsy |
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| Anmerkungen: |
Date Revised 26.07.2022 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
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| doi: |
10.3389/fmed.2022.874307 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM343926741 |
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| 100 | 1 | |a Ramos-Rincon, Jose-Manuel |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Pathological Findings Associated With SARS-CoV-2 on Postmortem Core Biopsies |b Correlation With Clinical Presentation and Disease Course |
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| 500 | |a Date Revised 26.07.2022 | ||
| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a Copyright © 2022 Ramos-Rincon, Herrera-García, Silva-Ortega, Portilla-Tamarit, Alenda, Jaime-Sanchez, Arenas-Jiménez, Fornés-Riera, Scholz, Escribano, Pedrero-Castillo, Muñoz-Miguelsanz, Orts-Llinares, Martí-Pastor, Amo-Lozano, García-Sevila, Ribes-Mengual, Moreno-Perez, Concepcion-Aramendía, Merino, Sánchez-Martínez and Aranda. | ||
| 520 | |a Background: Autopsies can shed light on the pathogenesis of new and emerging diseases | ||
| 520 | |a Aim: To describe needle core necropsy findings of the lung, heart, and liver in decedents with COVID-19 | ||
| 520 | |a Material: Cross-sectional study of needle core necropsies in patients who died with virologically confirmed COVID-19. Histopathological analyses were performed, and clinical data and patient course evaluated | ||
| 520 | |a Results: Chest core necropsies were performed in 71 decedents with a median age of 81 years (range 52-97); 47 (65.3%) were men. The median interval from symptoms onset to death was 17.5 days (range 1-84). Samples of lung (n = 62, 87.3%), heart (n = 48, 67.6%) and liver (n = 39, 54.9%) were obtained. Fifty-one lung samples (82.3%) were abnormal: 19 (30.6%) showed proliferative diffuse alveolar damage (DAD), 12 (19.4%) presented exudative DAD, and 10 (16.1%) exhibited proliferative plus exudative DAD. Of the 46 lung samples tested for SARS-CoV-19 by RT-PCR, 39 (84.8%) were positive. DAD was associated with premortem values of lactate dehydrogenase of 400 U/L or higher [adjusted odds ratio (AOR) 21.73; 95% confidence interval (CI) 3.22-146] and treatment with tocilizumab (AOR 6.91; 95% CI 1.14-41.7). Proliferative DAD was associated with an onset-to-death interval of over 15 days (AOR 7.85, 95% CI 1.29-47.80). Twenty-three of the 48 (47.9%) heart samples were abnormal: all showed fiber hypertrophy, while 9 (18.8%) presented fibrosis. Of the liver samples, 29/39 (74.4%) were abnormal, due to steatosis (n = 12, 30.8%), cholestasis (n = 6, 15.4%) and lobular central necrosis (n = 5, 12.8%) | ||
| 520 | |a Conclusion: Proliferative DAD was the main finding on lung core needle necropsy in people who died from COVID-19; this finding was related to a longer disease course. Changes in the liver and heart were common | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a SARS-CoV-2 | |
| 650 | 4 | |a autopsy | |
| 650 | 4 | |a coronavirus | |
| 650 | 4 | |a pathology | |
| 700 | 1 | |a Herrera-García, Cristian |e verfasserin |4 aut | |
| 700 | 1 | |a Silva-Ortega, Sandra |e verfasserin |4 aut | |
| 700 | 1 | |a Portilla-Tamarit, Julia |e verfasserin |4 aut | |
| 700 | 1 | |a Alenda, Cristina |e verfasserin |4 aut | |
| 700 | 1 | |a Jaime-Sanchez, Francisco-Angel |e verfasserin |4 aut | |
| 700 | 1 | |a Arenas-Jiménez, Juan |e verfasserin |4 aut | |
| 700 | 1 | |a Fornés-Riera, Francisca-Eugenia |e verfasserin |4 aut | |
| 700 | 1 | |a Scholz, Alexander |e verfasserin |4 aut | |
| 700 | 1 | |a Escribano, Isabel |e verfasserin |4 aut | |
| 700 | 1 | |a Pedrero-Castillo, Víctor |e verfasserin |4 aut | |
| 700 | 1 | |a Muñoz-Miguelsanz, Carlos |e verfasserin |4 aut | |
| 700 | 1 | |a Orts-Llinares, Pedro |e verfasserin |4 aut | |
| 700 | 1 | |a Martí-Pastor, Ana |e verfasserin |4 aut | |
| 700 | 1 | |a Amo-Lozano, Antonio |e verfasserin |4 aut | |
| 700 | 1 | |a García-Sevila, Raquel |e verfasserin |4 aut | |
| 700 | 1 | |a Ribes-Mengual, Isabel |e verfasserin |4 aut | |
| 700 | 1 | |a Moreno-Perez, Oscar |e verfasserin |4 aut | |
| 700 | 1 | |a Concepcion-Aramendía, Luis |e verfasserin |4 aut | |
| 700 | 1 | |a Merino, Esperanza |e verfasserin |4 aut | |
| 700 | 1 | |a Sánchez-Martínez, Rosario |e verfasserin |4 aut | |
| 700 | 1 | |a Aranda, Ignacio |e verfasserin |4 aut | |
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