Organ changes found by postmortem examination in COVID-19 patients

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The postmortem study results presented in 20 sources of literature on 186 COVID-19 patients were analyzed. Pathological changes were noted in multiple organs, by involving predominantly the respiratory, circulatory, and excretory systems. The changes in the lungs were characterized by an increase in organ weight (59.3%), a dark red color of the parenchyma (47.4%), compaction of lung tissue (56%), and signs of lung congestion (37.3%). The histological characteristics found during postmortem lung tissue examination, which were indicative of diffuse alveolar damage, were proliferation of type II alveolocytes in 65.2% of cases, the appearance of hyaline membranes lining the alveoli in 64.4%, and interstitial edema in 54.2%. In the analyzed sources, 22% of cases were noticed to have severe thrombosis and pulmonary artery branch embolism that was associated with lower extremity deep vein thrombosis. In all the sources of literature, acute tubular necrosis, tubular luminal dilatation, and interstitial edema were detected in the kidneys.

Keywords:

SARS-CoV-2

COVID-19

acute respiratory distress syndrome

diffuse alveolar damage

Authors:

Odilov A.A.

Peoples’ Friendship University of Russia

Tsimbalist N.S.

Peoples’ Friendship University of Russia

Volkov A.V.

Sechenov First Moscow State Medical University (Sechenov University)

ORCID: 0000-0002-1873-0189

Babichenko I.I.

Peoples’ Friendship University of Russia;
Central Research Institute of Dentistry and Maxillofacial Surgery

ORCID: 0000-0001-5512-6813

Received:

05.07.2020

Accepted:

16.09.2020

List of references:

Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, Ren R, Leung KSM, Lau EHY, Wong JY, Xing X, Xiang N, Wu Y, Li C, Chen Q, Li D, et al. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected neumonia. N Engl J Med. 2020;382(13):1199-1207. https://doi.org/10.1056/nejmoa2001316
Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, Zhao X, Huang B, Shi W, Lu R, Niu P, Zhan F, Ma X, Wang D, Xu W, Wu G, Gao GF, Tan W. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382(8):727-733. https://doi.org/10.1056/nejmoa2001017
WHO. Naming the coronavirus disease (COVID-19) and the virus that causes it. Accessed June 24, 2020. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/naming-the-coronavirus-disease-(covid-2019)-and-the-virus-that-causes-it
WHO Director-General’s opening remarks at the media briefing on COVID-19 — 11 March 2020. Accessed June 24, 2020. https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020
Report on the current situation with coronavirus in the Russian Federation: statistics, data from the regions, measures of the Government of the Russian Federation. Accessed June 22, 2020. (In Russ.). https://xn--80aesfpebagmfblc0a.xn--p1ai/ai/html/3/attach/2020-06-21_coronavirus_government_report.pdf
Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, Qiu Y, Wang J, Liu Y, Wei Y, Xia J, Yu T, Zhang X, Zhang L. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507-513. https://doi.org/10.1016/s0140-6736(20)30211-7
Zayratyants OV, Samsonova MV, Mikhaleva LM, Cherniaev AL, Mishnev OD, Krupnov NM, Kalinin DV. Pathological anatomy of COVID-19: Atlas. Zayratyants OV, ed. M.: GBU «NIIOZMM DZM»; 2020. Accessed June 22, 2020. (In Russ.) https://mosgorzdrav.ru/uploads/imperavi/ru-RU/patanatomiya_covid19_fullv2_compressed.pdf
Wu JH, Li X, Huang B, Su H, Li Y, Luo DJ, Chen S, Ma L, Wang SH, Nie X, Peng L. Pathological changes of fatal coronavirus disease 2019 (COVID-19) in the lungs: report of 10 cases by postmortem needle autopsy. Zhonghua Bing Li Xue Za Zhi. 2020;49(6):568-575. https://doi.org/10.3760/cma.j.cn112151-20200405-00291
Tian S, Hu W, Niu L, Liu H, Xu H, Xiao SY. Pulmonary pathology of early-phase 2019 novel coronavirus (COVID-19) pneumonia in two patients with lung cancer. J Thorac Oncol. 2020;15(5):700-704. https://doi.org/10.1016/j.jtho.2020.02.010
Zhang T, Sun LX, Feng RE. Comparison of clinical and pathological features between severe acute respiratory syndrome and coronavirus disease 2019. Zhonghua Jie He He Hu Xi Za Zhi. 2020; 43(6):496-502. https://doi.org/10.3760/cma.j.cn112147-20200311-00312
Nicholls JM, Poon LL, Lee KC, Ng WF, Lai ST, Leung CY, Chu CM, Hui PK, Mak KL, Lim W, Yan KW, Chan KH, Tsang NC, Guan Y, Yuen KY, Peiris JS. Lung pathology of fatal severe acute respiratory syndrome. Lancet. 2003;361(9371):1773-1778. https://doi.org/10.1016/s0140-6736(03)13413-7
Alsaad KO, Hajeer AH, Al Balwi M, Al Moaiqel M, Al Oudah N, Al Ajlan A, AlJohani S, Alsolamy S, Gmati GE, Balkhy H, Al-Jahdali HH, Baharoon SA, Arabi YM. Histopathology of Middle East respiratory syndrome coronovirus (MERS-CoV) infection — clinicopathological and ultrastructural study. Histopathology. 2018;72(3):516-524. https://doi.org/10.1111/his.13379
Voltersvik P, Aqrawi LA, Dudman S, Hungnes O; Norwegian Lung Pathology Group, Bostad L, Brokstad KA, Cox RJ. Pulmonary changes in Norwegian fatal cases of pandemic influenza H1N1 (2009) infection: a morphologic and molecular genetic study. Influenza Other Respir Viruses. 2016;10(6):525-531. https://doi.org/10.1111/irv.12410
Xu Z, Shi L, Wang Y, Zhang J, Huang L, Zhang C, Liu S, Zhao P, Liu H, Zhu L, Tai Y, Bai C, Gao T, Song J, Xia P, Dong J, Zhao J, Wang FS. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med. 2020;8(4):420-422. https://doi.org/10.1016/s2213-2600(20)30076-x
Liu Q, Wang RS, Qu GQ, Wang YY, Liu P, Zhu YZ, Fei G, Ren L, Zhou YW, Liu L. Gross examination report of a COVID-19 death autopsy. Fa Yi Xue Za Zhi. 2020;36(1):21-23. https://doi.org/10.12116/j.issn.1004-5619.2020.01.005
Yao XH, Li TY, He ZC, Ping YF, Liu HW, Yu SC, Mou HM, Wang LH, Zhang HR, Fu WJ, Luo T, Liu F, Guo QN, Chen C, Xiao HL, et al. A pathological report of three COVID-19 cases by minimal invasive autopsies. Zhonghua Bing Li Xue Za Zhi. 2020;49(5):411-417. https://doi.org/10.3760/cma.j.cn112151-20200312-00193
Konopka KE, Wilson A, Myers JL. Postmortem lung findings in an asthmatic patient with coronavirus disease 2019. Chest. 2020;158(3):99-101. https://doi.org/10.1016/j.chest.2020.04.032
Menter T, Haslbauer JD, Nienhold R, Savic S, Hopfer H, Deigendesch N, Frank S, Turek D, Willi N, Pargger H, Bassetti S, Leuppi JD, Cathomas G, Tolnay M, Mertz KD, Tzankov A. Post-mortem examination of COVID19 patients reveals diffuse alveolar damage with severe capillary congestion and variegated findings of lungs and other organs suggesting vascular dysfunction. Histopathology. 2020. https://doi.org/10.1111/his.14134
Barton LM, Duval EJ, Stroberg E, Ghosh S, Mukhopadhyay S. COVID-19 Autopsies, Oklahoma, USA. Am J Clin Pathol. 2020; 153(6):725-733. https://doi.org/10.1093/ajcp/aqaa062
Wichmann D, Sperhake JP, Lütgehetmann M, Steurer S, Edler C, Heinemann A, Heinrich F, Mushumba H, Kniep I, Schröder AS, Burdelski C, de Heer G, Nierhaus A, Frings D, Pfefferle S, et al. Autopsy findings and venous thromboembolism in patients with COVID-19. Ann Intern Med. 2020;173(4):268-277. https://doi.org/10.7326/m20-2003
Buja LM, Wolf DA, Zhao B, Akkanti B, McDonald M, Lelenwa L, Reilly N, Ottaviani G, Elghetany MT, Trujillo DO, Aisenberg GM, Madjid M, Kar B. The emerging spectrum of cardiopulmonary pathology of the coronavirus disease 2019 (COVID-19): Report of 3 autopsies from Houston, Texas, and review of autopsy findings from other United States cities. Cardiovasc Pathol. 2020;48:107233. https://doi.org/10.1016/j.carpath.2020.107233
Craver R, Huber S, Sandomirsky M, McKenna D, Schieffelin J, Finger L. Fatal eosinophilic myocarditis in a healthy 17-year-old male with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2c). Fetal Pediatr Pathol. 2020;39(3):263-268. https://doi.org/10.1080/15513815.2020.1761491
Lax SF, Skok K, Zechner P, Kessler HH, Kaufmann N, Koelblinger C, Vander K, Bargfrieder U, Trauner M. Pulmonary arterial thrombosis in COVID-19 with fatal outcome: results from a prospective, single-center, clinicopathologic case series. Ann Intern Med. 2020;173(5):350-361. https://doi.org/10.7326/M20-2566
Adachi T, Chong JM, Nakajima N, Sano M, Yamazaki J, Miyamoto I, Nishioka H, Akita H, Sato Y, Kataoka M, Katano H, Tobiume M, Sekizuka T, Itokawa K, Kuroda M, Suzuki T. Clinicopathologic and immunohistochemical findings from autopsy of patient with COVID-19, Japan. Emerg Infect Dis. 2020;26(9):2157-2161. https://doi.org/10.3201/eid2609.201353
Yan L, Mir M, Sanchez P, Beg M, Peters J, Enriquez O, Gilbert A. COVID-19 in a Hispanic woman. Arch Pathol Lab Med. 2020; 144(9):1041-1047. https://doi.org/10.5858/arpa.2020-0217-SA
Ackermann M, Verleden SE, Kuehnel M, Haverich A, Welte T, Laenger F, Vanstapel A, Werlein C, Stark H, Tzankov A, Li WW, Li VW, Mentzer SJ, Jonigk D. Pulmonary vascular endothelialitis, thrombosis, and angiogenesis in Covid-19. N Engl J Med. 2020;383(2):120-128. https://doi.org/10.1056/nejmoa2015432
Martines RB, Ritter JM, Matkovic E, Gary J, Bollweg BC, Bullock H, Goldsmith CS, Silva-Flannery L, Seixas JN, Reagan-Steiner S, Uyeki T, Denison A, Bhatnagar J, Shieh WJ, Zaki SR; COVID-19 Pathology Working Group. Pathology and pathogenesis of SARS-CoV-2 associated with fatal coronavirus disease, United States. Emerg Infect Dis. 2020;26(9):2005-2015. https://doi.org/10.3201/eid2609.202095
Schaller T, Hirschbühl K, Burkhardt K, Braun G, Trepel M, Märkl B, Claus R. Postmortem examination of patients with COVID-19. JAMA. 2020;323(24):2518-2520. https://doi.org/10.1001/jama.2020.8907
Nunes Duarte-Neto A, de Almeida Monteiro RA, da Silva LFF, Malheiros DMAC, de Oliveira EP, Theodoro Filho J, Pinho JRR, Soares Gomes-Gouvêa M, Salles APM, de Oliveira IRS, Mauad T, do Nascimento Saldiva PH, Dolhnikoff M Pulmonary and systemic involvement of COVID-19 assessed by ultrasound-guided minimally invasive autopsy. Histopathology. 2020. https://doi.org/10.1111/his.14160
Sekulic M, Harper H, Nezami BG, Shen DL, Sekulic SP, Koeth AT, Harding CV, Gilmore H, Sadri N. Molecular detection of SARS-CoV-2 infection in FFPE samples and histopathologic findings in fatal SARS-CoV-2 cases. Am J Clin Pathol. 2020;154(2): 190-200. https://doi.org/10.1093/ajcp/aqaa091
Aguiar D, Lobrinus JA, Schibler M, Fracasso T, Lardi C. Inside the lungs of COVID-19 disease. Int J Legal Med. 2020;134(4):1271-1274. https://doi.org/10.1007/s00414-020-02318-9
Fox SE, Akmatbekov A, Harbert JL, Li G, Quincy Brown J, Vander Heide RS. Pulmonary and cardiac pathology in African American patients with COVID-19: an autopsy series from New Orleans. Lancet Respir Med. 2020;8(7):681-686. https://doi.org/10.1016/s2213-2600(20)30243-5
Edler C, Schröder AS, Aepfelbacher M, Fitzek A, Heinemann A, Heinrich F, Klein A, Langenwalder F, Lütgehetmann M, Meißner K, Püschel K, Schädler J, Steurer S, Mushumba H, Sperhake JP. Dying with SARS-CoV-2 infection-an autopsy study of the first consecutive 80 cases in Hamburg, Germany. Int J Legal Med. 2020; 134(4):1275-1284. https://doi.org/10.1007/s00414-020-02317-w

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