Morphopathological features induced by SARS-CoV-2 infection - a series of 57 autopsies
Mariana Deacu1,2, Manuela Enciu1,2, Antonela-Anca Nicolau1,3, Gabriela Izabela Bălţătescu1,3, Lavinia Simona Neculai-Cândea2,4, Sorin Deacu2,4 and Marius Florentin Popa2,4
1Clinical Pathology Service, St. Apostle Andrew Emergency County Hospital, 2Faculty of Medicine, Ovidius University of Constanţa, 3Center for Research and Development of The Morphological and Genetic Studies of Malignant Pathology (CEDMOG), Ovidius University of Constanţa and 4Clinical Forensic County Service, Sf. St. Apostle Andrew Emergency County Hospital, Constanţa, Romania
Corresponding Author: Gabriela Izabela Bălţătescu MD, PhD, Clinical Service of Pathology, St. Apostle Andrew Emergency County Hospital; Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology (CEDMOG), “Ovidius” University of Constanţa, 1 Universităţii Lane, 900470 Constanţa, Romania. e-mail: Gabriela.baltatescu@univ-ovidius.ro or Gabrielabaltatestu@yahoo.com
Summary. Background. COVID-19 is a systemic disease with multiorgan damage, which requires a better understanding and deepening of histopathogenesis in order to improve treatment. Autopsy remains a gold standard to establish certain diagnoses and to integrate the morphological spectrum of lung lesions, explaining the cause of death, into a clinical context.
Methods and Results. The study included 57 autopsies performed during 2020-2021 associated with SARS-CoV-2 infection. Among the autopsies we performed, diffuse alveolar damage (DAD) was the most common pulmonary morphological change, 31.8% of them with acute or exudative phase and 33.3% with proliferative phase of DAD. Acute fibrous organizing pneumonia or organizing pneumonia with fibrous remodeling processes and pulmonary fibrosis were rarely observed. The most unfavorable outcome and death associated with SARS-CoV-2 infection was frequent in older men, with a high rate of comorbidities. Microscopically, SARS-CoV-2 presents many common aspects with MERS-CoV and SARS-CoV-1, such as alveolar hyaline membrane, desquamated alveolar cells, alveolar edema and alveolar and interstitial lymphocyte and monocytes infiltration.
Conclusions. Our study includes a large number of autopsies on patients with SARS-CoV-2 infection performed in Romania. COVID 19 associated pneumonia combines classical aspects of alveolar and interstitial pneumonia with some peculiarities. Autopsies are of major importance in understanding SARS-CoV-2 infection. Histol Histopathol 38, 513-524 (2023)
Key words: Diffuse alveolar damage, SARS-CoV-2, COVID-19, Morphopathology, pneumonia
DOI: 10.14670/HH-18-561
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©The Author(s) 2023. Open Access. This article is licensed under a Creative Commons CC-BY International License. |
