Postmortem examination of three SARS-CoV-2-positive autopsies including histopathologic and immunohistochemical analysis
Postmortem examination of three SARS-CoV-2-positive autopsies including histopathologic and immunohistochemical analysis
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DOI：
10.1007/s00414-020-02406-w
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发表时间：
2020-08-27
影响因子：
2.1
通讯作者：
Muja, Lilioara-Alexandra
中科院分区：
文献类型：
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作者：
Oprinca, George-Calin;Muja, Lilioara-Alexandra
本文描述了三例尸检后诊断为SARS-CoV-2感染的病例，并对收集的器官组织进行了详细的宏观检查和先进的显微镜研究，使用苏木精-伊红染色和免疫组织化学标记物。其中两例曾在锡比乌县临床急诊医院短暂收治，其中一人被发现死于其家庭住址。所有三例尸检均在COVID-19限制区内的县停尸房完成，使用了完整的防护设备。患者的肺似乎是新型冠状病毒侵袭和发病的中心器官，具有弥漫性冷凝区、胸膜下缩回区，但与典型细菌性支气管肺炎有不同的表现。显微镜检查显示II型肺细胞的病毒性细胞病变，有几个细胞呈现细胞质和核包涵体，并倾向于形成类似多核巨细胞的团簇。我们几乎所有的三个病例都经常发现透明膜和肺泡壁的破坏以及小血管内的微血栓形成。脾髓白色萎缩，无淋巴滤泡。显微镜下心肌及其他脏器未见病毒感染征象。
This paper describes three autopsy cases with postmortem diagnosis of SARS-CoV-2 infection, with detailed macroscopic examination as well as advanced microscopic studies of organ tissues collected using hematoxylin-eosin stains and immunohistochemical markers. Two of the cases were admitted briefly in the County Clinical Emergency Hospital of Sibiu, and one was found deceased at his home address. All three autopsies were completed at the County morgue, in the COVID-19 restricted area, using complete protective equipment. The lungs of the patients seemed to be the center organ of invasion and pathogenesis of the novel coronavirus with diffuse areas of condensation, subpleural retraction zones but with different aspect of the classic bacterial bronchopneumonia. Microscopic evaluation revealed viral cytopathic effect of type II pneumocytes with a couple of cells that presented cytoplasmic and nuclear inclusions and who tend to form clusters mimicking multinucleated giant cells. Hyaline membranes and destruction of the alveolar wall as well as microthrombi formation within the small blood vessels were constantly found in almost all our three cases. The spleen had sustained white pulp atrophy with absence of lymphoid follicles. There were no microscopic signs of viral infection on the myocardium or the other organs.