Bibliographic Details
| Title: |
Unspecific post-mortem findings despite multiorgan viral spread in COVID-19 patients |
| Authors: |
Myriam Remmelink, Ricardo De Mendonça, Nicky D’Haene, Sarah De Clercq, Camille Verocq, Laetitia Lebrun, Philomène Lavis, Marie-Lucie Racu, Anne-Laure Trépant, Calliope Maris, Sandrine Rorive, Jean-Christophe Goffard, Olivier De Witte, Lorenzo Peluso, Jean-Louis Vincent, Christine Decaestecker, Fabio Silvio Taccone, Isabelle Salmon |
| Source: |
Critical Care, Vol 24, Iss 1, Pp 1-10 (2020) |
| Publisher Information: |
BMC, 2020. |
| Publication Year: |
2020 |
| Collection: |
LCC:Medical emergencies. Critical care. Intensive care. First aid |
| Subject Terms: |
COVID-19, SARS-CoV-2, Autopsy, RT-PCR, Immunohistochemistry, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9 |
| More Details: |
Abstract Background Post-mortem studies can provide important information for understanding new diseases and small autopsy case series have already reported different findings in COVID-19 patients. Methods We evaluated whether some specific post-mortem features are observed in these patients and if these changes are related to the presence of the virus in different organs. Complete macroscopic and microscopic autopsies were performed on different organs in 17 COVID-19 non-survivors. Presence of SARS-CoV-2 was evaluated with immunohistochemistry (IHC) in lung samples and with real-time reverse-transcription polymerase chain reaction (RT-PCR) test in the lung and other organs. Results Pulmonary findings revealed early-stage diffuse alveolar damage (DAD) in 15 out of 17 patients and microthrombi in small lung arteries in 11 patients. Late-stage DAD, atypical pneumocytes, and/or acute pneumonia were also observed. Four lung infarcts, two acute myocardial infarctions, and one ischemic enteritis were observed. There was no evidence of myocarditis, hepatitis, or encephalitis. Kidney evaluation revealed the presence of hemosiderin in tubules or pigmented casts in most patients. Spongiosis and vascular congestion were the most frequently encountered brain lesions. No specific SARS-CoV-2 lesions were observed in any organ. IHC revealed positive cells with a heterogeneous distribution in the lungs of 11 of the 17 (65%) patients; RT-PCR yielded a wide distribution of SARS-CoV-2 in different tissues, with 8 patients showing viral presence in all tested organs (i.e., lung, heart, spleen, liver, colon, kidney, and brain). Conclusions In conclusion, autopsies revealed a great heterogeneity of COVID-19-associated organ injury and the remarkable absence of any specific viral lesions, even when RT-PCR identified the presence of the virus in many organs. |
| Document Type: |
article |
| File Description: |
electronic resource |
| Language: |
English |
| ISSN: |
1364-8535 |
| Relation: |
http://link.springer.com/article/10.1186/s13054-020-03218-5; https://doaj.org/toc/1364-8535 |
| DOI: |
10.1186/s13054-020-03218-5 |
| Access URL: |
https://doaj.org/article/978a832615f44b4db34ea1501648bc10 |
| Accession Number: |
edsdoj.978a832615f44b4db34ea1501648bc10 |
| Database: |
Directory of Open Access Journals |
