Pathological anatomy of the new coronavirus infection COVID-19 according to autopsy materials 2020

• Published in: Uchenye zapiski (Sankt-Peterburgskiĭ gosudarstvennyĭ medit͡s︡inskiĭ universitet im. akad. I.P. Pavlova) Vol. 28; no. 3; pp. 39 - 46
• Main Authors: Rybakova, M. G., Fionik, A. M., Danilova, D. M., Myurzep, A. E., Sycheva, A. M., Tsaregorodtseva, A. D.
• Format: Journal Article
• Language: English; Russian
• Published: Academician I.P. Pavlov First St. Petersburg State Medical University 01.04.2022
• Subjects: diffuse alveolar damage; new coronavirus infection; regeneration; viral-bacterial pneumonia
• ISSN: 1607-4181; 2541-8807
• DOI: 10.24884/1607-4181-2021-28-3-39-46

Introduction. Organ lesions due to the new coronavirus infection are determined by several factors: direct cytopathic effect of SARS-CoV-2, release of an unbalanced amounts of proinflammatory cytokines leads to systemic damage of the vascular endothelium and increasing hypoxia. These factors in total result in organ dysfunction. Methods and materials. We examined 96 pathological studies’ protocols of patients who died from the PCR-confirmed new coronavirus infection. Histological slides stained with hematoxylin and eosin were also analyzed. Results. Macroscopical and microscopical changes seen mostly in lungs, myocardium and other internal organs were described. We reviewed main causes of death (pulmonary and cardiopulmonary failure, multiple organ dysfunction syndrome) and most common concomitant diseases (diabetes mellitus, essential hypertension, obesity). The morphological features of diffuse alveolar damage in the acute and proliferative phases were described in detail. Taken together with the synchronous involvement of the microvasculature in the pathological process it became the main cause of death. The most severe structural changes in lungs were seen after 20 days of disease. These changes were correlated with dysregenerative metaplastic and dysplastic processes. Processes of disturbed regeneration reflect both the severe viral transformation of the alveolar epithelium and the fact that regeneration developed under mechanical ventilation.