A Japanese case of COVID‐19: An autopsy report

• Published in: Pathology international Vol. 70; no. 10; pp. 820 - 824
• Main Authors: Okudela, Koji, Hayashi, Hiroyuki, Yoshimura, Yukihiro, Sasaki, Hiroaki, Horiuchi, Hiroshi, Miyata, Nobuyuki, Tachikawa, Natsuo, Tsuchiya, Yuki, Mitsui, Hideaki, Ohashi, Kenichi
• Format: Journal Article
• Language: English
• Published: Australia Wiley Subscription Services, Inc 01.10.2020; John Wiley and Sons Inc
• Subjects: Aged, 80 and over; Alveoli; Antiviral agents; Autopsies; Autopsy; Betacoronavirus - isolation & purification; Case Report; Case Reports; Clinical Laboratory Techniques; Computed tomography; Coronaviridae; Coronavirus Infections - diagnosis; Coronavirus Infections - pathology; Coronavirus Infections - therapy; Coronaviruses; Cough; COVID-19; COVID-19 Testing; diffuse alveolar damage; Fatal Outcome; Female; Humans; Infectious diseases; Japan; Japanese case; Lungs; Organs; Oxygen content; Pandemics; Pneumocytes; Pneumonia, Viral - diagnosis; Pneumonia, Viral - pathology; Pneumonia, Viral - therapy; Polymerase chain reaction; SARS-CoV-2; Severe acute respiratory syndrome; Severe acute respiratory syndrome coronavirus 2; Sputum; Steroids; Thorax; Viral diseases; Japan; COVID-19; Japanese case; diffuse alveolar damage
• ISSN: 1320-5463; 1440-1827; 1440-1827
• DOI: 10.1111/pin.13002

A 93‐year‐old woman was admitted with a 10‐day history of cough and prostration. Thoracic computed tomography revealed extensive ground‐glass opacities in both the lungs. The polymerase chain reaction test of sputum for severe acute respiratory syndrome‐coronavirus‐2 (SARS‐CoV‐2) was positive. She was treated with antiviral agents and steroid pulse therapy. However, her oxygen saturation gradually declined, and she died 10 days after hospitalization. The most important autopsy finding was fuzzily segmented diffuse alveolar damage (DAD) that expanded from the subpleural to the medial area. No remarkable changes were observed in organs other than the lungs. Therefore, pneumocytes were suggested as the primary target for SARS‐CoV‐2, which might explain why coronavirus infectious disease‐19 is a serious condition. Thus, early treatment is essential to prevent viral replication from reaching a level that triggers DAD.