The emerging spectrum of cardiopulmonary pathology of the coronavirus disease 2019 (COVID-19): Report of 3 autopsies from Houston, Texas, and review of autopsy findings from other United States cities
| Autor: | Bindu Akkanti, M. Tarek Elghetany, Giulia Ottaviani, Daniel Ocazionez Trujillo, L M Buja, Michelle McDonald, Laura Lelenwa, Gabriel M Aisenberg, Noah Reilly, Biswajit Kar, Bihong Zhao, Dwayne A. Wolf, Mohammad Madjid |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Adult Male Pathology medicine.medical_specialty Heart Diseases Health Status Pneumonia Viral Comorbidity 030204 cardiovascular system & hematology Pathology and Forensic Medicine 03 medical and health sciences Betacoronavirus 0302 clinical medicine Risk Factors Cause of Death medicine Humans Pulmonary pathology Diffuse alveolar damage Lung Pandemics Pneumonitis Aged Aged 80 and over business.industry SARS-CoV-2 Myocardium COVID-19 Dilated cardiomyopathy Heart General Medicine Middle Aged medicine.disease United States Pneumonia 030104 developmental biology medicine.anatomical_structure Viral pneumonia Acute Interstitial Pneumonia Host-Pathogen Interactions Female business Coronavirus Infections Cardiology and Cardiovascular Medicine |
| Zdroj: | Cardiovascular Pathology |
| ISSN: | 1054-8807 |
| DOI: | 10.1016/j.carpath.2020.107233 |
| Popis: | This paper collates the pathological findings from initial published autopsy reports on 23 patients with coronavirus disease 2019 (COVID-19) from 5 centers in the United States of America, including 3 cases from Houston, Texas. Findings confirm that COVID-19 is a systemic disease with major involvement of the lungs and heart. Acute COVID-19 pneumonia has features of a distinctive acute interstitial pneumonia with a diffuse alveolar damage component, coupled with microvascular involvement with intra- and extravascular fibrin deposition and intravascular trapping of neutrophils, and, frequently, with formation of microthombi in arterioles. Major pulmonary thromboemboli with pulmonary infarcts and/or hemorrhage occurred in 5 of the 23 patients. Two of the Houston cases had interstitial pneumonia with diffuse alveolar damage pattern. One of the Houston cases had multiple bilateral segmental pulmonary thromboemboli with infarcts and hemorrhages coupled with, in nonhemorrhagic areas, a distinctive interstitial lymphocytic pneumonitis with intra-alveolar fibrin deposits and no hyaline membranes, possibly representing a transition form to acute fibrinous and organizing pneumonia. Multifocal acute injury of cardiac myocytes was frequently observed. Lymphocytic myocarditis was reported in 1 case. In addition to major pulmonary pathology, the 3 Houston cases had evidence of lymphocytic pericarditis, multifocal acute injury of cardiomyocytes without inflammatory cellular infiltrates, depletion of splenic white pulp, focal hepatocellular degeneration and rare glomerular capillary thrombosis. Each had evidence of chronic cardiac disease: hypertensive left ventricular hypertrophy (420 g heart), dilated cardiomyopathy (1070 g heart), and hypertrophic cardiomyopathy (670 g heart). All 3 subjects were obese (BMIs of 33.8, 51.65, and 35.2 Kg/m2). Overall, the autopsy findings support the concept that the pathogenesis of severe COVID-19 disease involves direct viral-induced injury of multiple organs, including heart and lungs, coupled with the consequences of a procoagulant state with coagulopathy. |
| Databáze: | OpenAIRE |
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