"Dum spiro spero": clinicopathologic characteristics of SARS-CoV-2 infection

被引:2
作者
Tamas, Zombori [1 ]
Levente, Kuthi [1 ]
Tibor, Hortobagyi [1 ]
Erika, Csorgo [2 ]
Janos, Argyelan [2 ]
Lajos, Kocsis [2 ]
Istvan, Sejben [2 ]
Laszlo, Kaizer [1 ]
Bence, Radics [1 ]
Anita, Sejben [1 ]
Tamas, Pancsa [1 ]
Robert, Nyari Gergely [1 ]
Bence, Barath [1 ]
Gabor, Cserni [1 ,2 ]
Bela, Ivanyi [1 ]
Laszlo, Tiszlavicz [1 ]
机构
[1] Szegedi Tud Egyet, Altalanos Orvostud Kar, Patol Int, Szeged, Hungary
[2] Bacs Kiskun Megyei Oktatekorhaz, Kecskemet, Hungary
关键词
SARS-CoV-2; infection; clinicopathological findings; COVID-19; pneumonia; immunohistochemistry; CORONAVIRUS;
D O I
10.1556/650.2021.32387
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Introduction: Autopsy is an important tool for the evaluation of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. Objectice: The aim of this study was to present our experience with autopsies of patients diagnosed with SARS-CoV-2 infection. Method: Clinical data, macroscopic and microscopic findings of consecutive postmortems of non-vaccinated SARSCoV-2 patients are summarized. Lung samples were evaluated with SARS-CoV-2 nucleocapsid immunohistochemistry. Results: Autopsies were performed to determine the cause of death (n = 14), suspected tumours (n = 9) or due to legal obligation (n = 3). SARS-CoV-2 infection was verified by ante mortem (n = 22) , post mortem (n = 4) polymerase chain reaction. The mean duration of symptomatic disease was 12.9 days. Of 21 patients with COVID-19 pneumonia, 16 died of respiratory failure, 4 had additional bacterial pneumonia or Clostridioides difficile infection , 1 developed hemorrhagic complication (n = 1). Other causes of death included disseminated malignancies (n = 3), coronary thrombosis (n = 1) and pulmonary embolism (n = 1). The affected lungs were heavy and had patchy red appearance. Exudative or proliferative phases of diffuse alveolar damage (DAD) were detected with atypical pneu-mocytes. Microthrombosis (n = 7), macrothrombosis (n = 5) and pulmonary embolism (n = 4) were frequent. The SARS-CoV-2 immunohistochemical reaction was positive in 38.5% of cases. All patients had co-morbidities, namely, hypertension (n = 17), atherosclerosis (n = 14), diabetes (n = 8), malignancies (n = 6), chronic obstructive pulmonary diseases (n = 4), obesity (n = 3) and immunosuppression after kidney transplantation (n = 3). Conclusion: Fatal COVID-19 pneumonia occurred mostly in elderly males with co-morbidities. In the autopsy prac-tice, the SARS-CoV-2 nucleocapsid immunohistochemical reaction may confirm the infectious etiology in the early phase of DAD.
引用
收藏
页码:1791 / 1802
页数:12
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