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

Jose Manuel Ramos-Rincon, Cristian Herrera-García, Sandra Silva-Ortega, Julia Portilla-Tamarit, Cristina Alenda, Francisco Angel Jaime-Sanchez, Juan Arenas-Jiménez, Francisca Eugenia Fornés-Riera, Alexander Scholz, Isabel Escribano, Víctor Pedrero-Castillo, Carlos Muñoz-Miguelsanz, Pedro Orts-Llinares, Ana Martí-Pastor, Antonio Amo-Lozano, Raquel García-Sevila, Isabel Ribes-Mengual, Oscar Moreno-Perez, Luis Concepcion-Aramendía, Esperanza MerinoRosario Sánchez-Martínez, Ignacio Aranda

Producción científica: Contribución a una revistaArtículorevisión exhaustiva

3 Citas (Scopus)

Resumen

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.

Idioma originalInglés
Número de artículo874307
PublicaciónFrontiers in Medicine
Volumen9
DOI
EstadoPublicada - 7 jul. 2022
Publicado de forma externa

Áreas temáticas de ASJC Scopus

  • Medicina General

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