Virchows Arch . Autopsy findings after long-term treatment of COVID-19 patients with microbiological correlation

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Virchows Arch


. 2021 Jan 20.
doi: 10.1007/s00428-020-03014-0. Online ahead of print.
Autopsy findings after long-term treatment of COVID-19 patients with microbiological correlation


Katja Evert ¹ , Thomas Dienemann ² , Christoph Brochhausen ³ , Dirk Lunz ⁴ , Matthias Lubnow ⁵ , Markus Ritzka ² , Felix Keil ³ , Matthias Trummer ³ , Alexander Scheiter ³ , Bernd Salzberger ⁶ , Udo Reischl ⁷ , Peter Boor ⁸ , Andr? Gessner ⁷ , Jonathan Jantsch ⁷ , Diego F Calvisi ³ , Matthias Evert ³ , Barbara Schmidt ⁷ , Michaela Simon ⁷



Affiliations

• PMID: 33471172
• DOI: 10.1007/s00428-020-03014-0

Abstract

Between April and June 2020, i.e., during the first wave of pandemic coronavirus disease 2019 (COVID-19), 55 patients underwent long-term treatment in the intensive care unit at the University Hospital of Regensburg. Most of them were transferred from smaller hospitals, often due to the need for an extracorporeal membrane oxygenation system. Autopsy was performed in 8/17 COVID-19-proven patients after long-term treatment (mean: 33.6 days). Autopsy revealed that the typical pathological changes occurring during the early stages of the disease (e.g., thrombosis, endothelitis, capillaritis) are less prevalent at this stage, while severe diffuse alveolar damage and especially coinfection with different fungal species were the most conspicuous finding. In addition, signs of macrophage activation syndrome was detected in 7 of 8 patients. Thus, fungal infections were a leading cause of death in our cohort of severely ill patients and may alter clinical management of patients, particularly in long-term periods of treatment.

Keywords: Autopsy; COVID-19; Fungal infection; Macrophage activation syndrome; Mycosis.