COVID-19 Autopsies, Oklahoma, USA
COVID-19 Autopsies, Oklahoma, USA
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DOI：
10.1093/ajcp/aqaa062
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发表时间：
2020-06-01
影响因子：
3.5
通讯作者：
Mukhopadhyay, Sanjay
中科院分区：
文献类型：
--
作者：
Barton, Lisa M.;Duval, Eric J.;Mukhopadhyay, Sanjay
目的：报告2020年3月美国俄克拉荷马州两例严重急性呼吸综合征冠状病毒2（SARS - CoV - 2）阳性死亡个体的完整尸检方法和结果。
方法：在负压尸检室/隔离间，按照标准程序，使用包括N95口罩、护目镜和防护服在内的个人防护装备进行完整的尸检。通过对尸检拭子进行实时逆转录聚合酶链反应检测，确诊2019冠状病毒病（COVID - 19）。
结果：一名77岁肥胖男性，有高血压病史、脾切除史，发热寒战6天，在转运就医途中死亡。其尸检鼻咽拭子和肺实质拭子SARS - CoV - 2检测呈阳性。尸检显示弥漫性肺泡损伤以及支气管黏膜慢性炎症和水肿。一名42岁肥胖男性，有强直性肌营养不良病史，出现腹痛，随后发热、呼吸急促和咳嗽。尸检鼻咽拭子SARS - CoV - 2呈阳性；肺实质拭子呈阴性。尸检显示急性支气管肺炎伴吸入迹象。两例尸检均未发现病毒包涵体、气道黏液堵塞、嗜酸性粒细胞或心肌炎。
结论：尸检时可进行SARS - CoV - 2检测。弥漫性肺泡损伤和气道炎症等尸检结果反映了真正与病毒相关的病理改变；其他结果则代表叠加的或不相关的过程。
Objectives: To report the methods and findings of two complete autopsies of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive individuals who died in Oklahoma (United States) in March 2020.Methods: Complete postmortem examinations were performed according to standard procedures in a negative-pressure autopsy suite/isolation room using personal protective equipment, including N95 masks, eye protection, and gowns. The diagnosis of coronavirus disease 2019 (COVID-19) was confirmed by real-time reverse transcriptase polymerase chain reaction testing on postmortem swabs.Results: A 77-year-old obese man with a history of hypertension, splenectomy, and 6 days of fever and chills died while being transported for medical care. He tested positive for SARS-CoV-2 on postmortem nasopharyngeal and lung parenchymal swabs. Autopsy revealed diffuse alveolar damage and chronic inflammation and edema in the bronchial mucosa. A 42-year-old obese man with a history of myotonic dystrophy developed abdominal pain followed by fever, shortness of breath, and cough. Postmortem nasopharyngeal swab was positive for SARS-CoV-2; lung parenchymal swabs were negative. Autopsy showed acute bronchopneumonia with evidence of aspiration. Neither autopsy revealed viral inclusions, mucus plugging in airways, eosinophils, or myocarditis.Conclusions: SARS-CoV-2 testing can be performed at autopsy. Autopsy findings such as diffuse alveolar damage and airway inflammation reflect true virus-related pathology; other findings represent superimposed or unrelated processes.