Anatomical pathology of novel coronavirus (COVID-19) infection. First impressions

• Published in: Arkhiv patologii Vol. 82; no. 5; p. 5
• Main Authors: Rybakova, M G, Karev, V E, Kuznetsova, I A
• Format: Journal Article
• Language: Russian
• Published: Russia (Federation) 2020
• Subjects: Autopsy; Betacoronavirus - pathogenicity; Cause of Death; Coronavirus Infections - mortality; Coronavirus Infections - pathology; Coronavirus Infections - virology; COVID-19; Humans; Pandemics; Pneumonia, Viral - mortality; Pneumonia, Viral - pathology; Pneumonia, Viral - virology; SARS-CoV-2; anatomical pathology; novel coronavirus COVID-19 infection
• ISSN: 0004-1955
• DOI: 10.17116/patol2020820515

To date, descriptive results of a clinical and morphological study of novel coronavirus COVID-19 infection, mainly of the lungs, have appeared. However, in other organs, primarily in the cardiovascular system, there are substantial structural changes that lead to multiple organ dysfunction and contribute to death. To analyze the thanatogenetic significance of novel coronavirus COVID-19 infection in different age and gender groups and to describe the main morphopathological manifestations in various organs. The investigators carried out a comprehensive analysis of 700 autopsies of people disease from the novel coronavirus COVID-19 infection, which included an examination of gross changes reflected in the autopsy protocols and forensic medical examination reports, as well as that of microscopic changes detected during histological examination of organs. Immunohistochemistry (IHC) using mouse or rabbit antibodies to CD34, CD68, EMA, Ki67, caspase-3, and VEGF was employed in some observations. The novel coronavirus COVID-19 infection was the primary cause of death. Acute respiratory and pulmonary heart failure and multiple organ dysfunction became the leading thanatogenetic mechanisms in COVID-19. Cardiovascular disease, diabetes mellitus, and obesity were the most common diseases in patients with COVID-19. The most pronounced lung changes in COVID-19 were determined with a predominance of multiple total bilateral lesions of the lower lobes of the lungs, which was manifested by virus-induced changes in the parenchyma and stroma, as well as by microcirculation disorders. Acute dyscirculatory and ischemic changes in the parenchymal organs dominated in tissue damage caused by the virus. The changes in different organs of those who have died from the new coronavirus COVID-19 infection are stereotyped and include the manifestations of virus-induced action and a systemic inflammatory response with mainly microvasculature alteration, which leads to the development of coagulopathies and, accordingly, to total hypoxia.