Pathological study of the 2019 novel coronavirus disease (COVID-19) through postmortem core biopsies
By S. Tian, Y. Xiong, Huan Liu, L. Niu, Jianchun Guo, Meiyan Liao, S. Xiao. Modern Pathology, 2020
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Data on pathologic changes of the 2019 novel coronavirus disease (COVID-19) are scarce. To gain knowledge about the pathology that may contribute to disease progression and fatality, we performed postmortem needle core biopsies of lung, liver, and heart in four patients who died of COVID-19 pneumonia. The patients’ ages ranged from 59 to 81, including three males and one female. Each patient had at least one underlying disease, including immunocompromised status (chronic lymphocytic leukemia and renal transplantation) or other conditions (cirrhosis, hypertension, and diabetes). Time from disease onset to death ranged from 15 to 52 days. All patients had elevated white blood cell counts, with significant rise toward the end, and all had lymphocytopenia except for the patient with leukemia. Histologically, the main findings are in the lungs, including injury to the alveolar epithelial cells, hyaline membrane formation, and hyperplasia of type II pneumocytes, all components of diffuse alveolar damage. Consolidation by fibroblastic proliferation with extracellular matrix and fibrin forming clusters in airspaces is evident. In one patient, the consolidation consists of abundant intra-alveolar neutrophilic infiltration, consistent with superimposed bacterial bronchopneumonia. The liver exhibits mild lobular infiltration by small lymphocytes, and centrilobular sinusoidal dilation. Patchy necrosis is also seen. The heart shows only focal mild fibrosis and mild myocardial hypertrophy, changes likely related to the underlying conditions. In conclusion, the postmortem examinations show advanced diffuse alveolar damage, as well as superimposed bacterial pneumonia in some patients. Changes in the liver and heart are likely secondary or related to the underlying diseases.
Subfields: Infectious Diseases, Neurology
View Paper: https://www.semanticscholar.org/paper/f9d0dfd6fb5172ac8b35fe804d80c4d3b0cec818
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Citations in the corpus
- Pulmonary Arterial Thrombosis in COVID-19 With Fatal Outcome: Results From a Prospective, Single-Center, Clinicopathologic Case Series (2020, background): “Notably, pulmonary thrombosis and thromboembolisms have been reported from autopsies of patients with SARS-1 (29), but until now, not of patients with COVID-19 (15, 19).”
- COVID-19 Image Data Collection: Prospective Predictions Are the Future (2020, methodology): “Transfer learning methods actively under development in the ML community such as few/zero-shot [Wang et al., 2019; Tian et al., 2020b; Larochelle et al., 2008; Ren et al., 2019], meta-learning [Andrychowicz et al., 2016; Snell et al., 2017], deep metric learning [Roth et al., 2020], and domain…”
- Chest CT score in COVID-19 patients: correlation with disease severity and short-term prognosis (2020, background): “These findings may explain the higher prevalence of crazy-paving pattern and consolidation areas that we have observed in our late disease population, which probably refer to a combination of alveolar edema, bacterial superinfection, and interstitial inflammatory changes [18].”