tetano
Editor, Senior Moderator
J Infect Dis
. 2020 Sep 11;jiaa578.
doi: 10.1093/infdis/jiaa578. Online ahead of print.
Post-Mortem Findings in Italian Patients with COVID-19 - a Descriptive Full Autopsy Study of cases with and without co-morbidities
Laura Falasca[SUP] 1 [/SUP], Roberta Nardacci[SUP] 1 [/SUP], Daniele Colombo[SUP] 1 [/SUP], Eleonora Lalle[SUP] 1 [/SUP], Antonino Di Caro[SUP] 1 [/SUP], Emanuele Nicastri[SUP] 1 [/SUP], Andrea Antinori[SUP] 1 [/SUP], Nicola Petrosillo[SUP] 1 [/SUP], Luisa Marchioni[SUP] 1 [/SUP], Gianluigi Biava[SUP] 1 [/SUP], Gianpiero D'Offizi[SUP] 1 [/SUP], Fabrizio Palmieri[SUP] 1 [/SUP], Delia Goletti[SUP] 1 [/SUP], Alimuddin Zumla[SUP] 2 [/SUP], Giuseppe Ippolito[SUP] 1 [/SUP], Mauro Piacentini[SUP] 1 3 [/SUP], Franca Del Nonno[SUP] 1 [/SUP]
Affiliations
Abstract
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 post-mortem studies restricted to the lung and specific organs. Whole body autopsy studies of COVID-19 patients have been sparse. To further define the pathology caused by SARS-CoV-2 across all body organs in both individuals with and without co-morbidities Italian patients who died of COVID-19.
Methods: We performed autopsies on 22 patients with COVID-19 (18 with co-morbidities and 4 without co-morbidities) 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 causes multisystem pathology. Pulmonary and cardiovascular involvement are dominant pathological features. Extra-pulmonary manifestations include hepatic, kidney, splenic and bone marrow involvement, and microvascular injury and thrombosis were also detected. These findings were similar in patients with or without pre-existing medical co-morbidities.
Conclusions: SARS-CoV-2 infection causes multisystem disease and significant pathology in most organs in patients with and without co-morbidities.
Keywords: Autopsy; COVID-19; SARS-CoV-2; co-morbidities; pathology.
. 2020 Sep 11;jiaa578.
doi: 10.1093/infdis/jiaa578. Online ahead of print.
Post-Mortem Findings in Italian Patients with COVID-19 - a Descriptive Full Autopsy Study of cases with and without co-morbidities
Laura Falasca[SUP] 1 [/SUP], Roberta Nardacci[SUP] 1 [/SUP], Daniele Colombo[SUP] 1 [/SUP], Eleonora Lalle[SUP] 1 [/SUP], Antonino Di Caro[SUP] 1 [/SUP], Emanuele Nicastri[SUP] 1 [/SUP], Andrea Antinori[SUP] 1 [/SUP], Nicola Petrosillo[SUP] 1 [/SUP], Luisa Marchioni[SUP] 1 [/SUP], Gianluigi Biava[SUP] 1 [/SUP], Gianpiero D'Offizi[SUP] 1 [/SUP], Fabrizio Palmieri[SUP] 1 [/SUP], Delia Goletti[SUP] 1 [/SUP], Alimuddin Zumla[SUP] 2 [/SUP], Giuseppe Ippolito[SUP] 1 [/SUP], Mauro Piacentini[SUP] 1 3 [/SUP], Franca Del Nonno[SUP] 1 [/SUP]
Affiliations
- PMID: 32914853
- DOI: 10.1093/infdis/jiaa578
Abstract
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 post-mortem studies restricted to the lung and specific organs. Whole body autopsy studies of COVID-19 patients have been sparse. To further define the pathology caused by SARS-CoV-2 across all body organs in both individuals with and without co-morbidities Italian patients who died of COVID-19.
Methods: We performed autopsies on 22 patients with COVID-19 (18 with co-morbidities and 4 without co-morbidities) 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 causes multisystem pathology. Pulmonary and cardiovascular involvement are dominant pathological features. Extra-pulmonary manifestations include hepatic, kidney, splenic and bone marrow involvement, and microvascular injury and thrombosis were also detected. These findings were similar in patients with or without pre-existing medical co-morbidities.
Conclusions: SARS-CoV-2 infection causes multisystem disease and significant pathology in most organs in patients with and without co-morbidities.
Keywords: Autopsy; COVID-19; SARS-CoV-2; co-morbidities; pathology.