Postmortem Findings in Italian Patients With COVID-19: A Descriptive Full Autopsy Study of Cases With and Without Comorbidities
Postmortem Findings in Italian Patients With COVID-19: A Descriptive Full Autopsy Study of Cases With and Without Comorbidities
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DOI：
10.1093/infdis/jiaa578
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发表时间：
2020-12-01
影响因子：
6.4
通讯作者：
Del Nonno, Franca
中科院分区：
文献类型：
--
作者：
Falasca, Laura;Nardacci, Roberta;Del Nonno, Franca
背景由新型人畜共患病原体严重急性呼吸道综合征冠状病毒-2（SARS-CoV-2）引起的2019冠状病毒病（COVID-19）的病理特征描述来自组织活检、病例报告和仅限于肺部和特定器官的小型尸检研究。COVID-19患者的全身尸检研究很少。为了进一步确定SARS-CoV-2在所有身体器官中引起的病理学，我们对22名死于意大利罗马国家传染病研究所Lazzaro Spallanzani-IRCCS医院的COVID-19患者（18名患有合并症，4名没有合并症）进行了尸检。检查了肺、心脏、肝脏、肾脏、脾脏和骨髓（但不包括大脑）的组织。仅对肺组织进行透射电镜观察。COVID-19导致多系统病变。肺部和心血管受累是主要病理特征。肺外表现包括肝、肾、脾和骨髓受累，还检测到微血管损伤和血栓形成。这些结果在有或没有既往医学合并症的患者中相似。SARS-CoV-2感染导致多系统疾病，并在有和无合并症的患者中在大多数器官中引起显著病理学改变。
Background. Descriptions of the pathological features of coronavirus disease-2019 (COVID-19) caused by the novel zoonotic pathogen severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) emanate from tissue biopsies, case reports, and small postmortem studies restricted to the lung and specific organs. Whole-body autopsy studies of COVID-19 patients have been sparse.Methods. To further define the pathology caused by SARS-CoV-2 across all body organs, we performed autopsies on 22 patients with COVID-19 (18 with comorbidities and 4 without comorbidities) who died at the National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS Hospital, Rome, Italy. Tissues from the lung, heart, liver, kidney, spleen, and bone marrow (but not the brain) were examined. Only lung tissues were subject to transmission electron microscopy.Results. COVID-19 caused multisystem pathology. Pulmonary and cardiovascular involvement were dominant pathological features. Extrapulmonary manifestations included hepatic, kidney, splenic, and bone marrow involvement, and microvascular injury and thrombosis were also detected. These findings were similar in patients with or without preexisting medical comorbidities.Conclusions. SARS-CoV-2 infection causes multisystem disease and significant pathology in most organs in patients with and without comorbidities.