Complete Autopsy Findings in Patients who Died from COVID-19: Literature Review
Autopsy Findings in Patients who Died from COVID-19
Keywords:
completed autopsy, full autopsy, COVID-19 related deathsAbstract
Thailand has accepted the death related COVID-19 infection is death by natural causes and practiced to not do an autopsy. Since no completed autopsy report, this systemic review has performed the empirical data of completed autopsy findings in autopsies of confirmed COVID-19. Two hundred and nineteen cases ranged in age from 19-100 years from eight studies were included. Almost 90% of cases had underlying diseases including cardiovascular diseases, arterial hypertension and chronic lung disease. The most common pathologic findings were heavy lungs, pulmonary edema and pulmonary embolism. The most common histopathology finding was diffuse alveolar damage (DAD), whereas other organs represented the chronic diseases or hemodynamic changes. However, the inflammatory infiltrate in various organs were described. Furthermore, microthrombi was also found in extrapulmonary organs such as heart, kidney and brain. These findings suggested that COVID-19 infection might be increased risk of systemic inflammatory response, coagulopathy and thrombotic. In conclusion, DAD and evidences of thromboembolism in multiple organs are the main findings in autopsies of COVID-19 patients.
References
On the 19th month, the death toll of COVID-19 in Thailand reaches 10,000 [online]. 2021 [cited 25 Oct 2021]. Available from: URL:https//www.bbc.com/thai/Thailand-58321371
Heath Administration Division, Office of Permanent Secretary, Ministry of Public Health. Corpse management guidelines in confirmed and suspected COVID-19 patients, revised edition. Bangkok, Thailand:Heath Administration Division, Office of Permanent Secretary, Ministry of Public Health; 2021.
Dell'Aquila M, Cattani P, Fantoni M, Marchetti S, Aquila I, Stigliano E, et al. Postmortem swabs in the severe acute respiratory syndrome Coronavirus 2 pandemic. Arch Pathol Lab Med 2020;144(11):1298-302.
Youd E, Moore L. COVID-19 autopsy in people who died in community settings:the first series. J Clin Pathol 2020;73(12):840-4.
Menter T, Haslbauer JD, Nienhold R, Savic S, Hopfer H, Deigendesch N, et al. Postmortem examination of COVID-19 patients reveals diffuse alveolar damage with severe capillary congestion and variegated findings in lungs and other organs suggesting vascular dysfunction. Histopathol 2020;77(2):198-209.
Wichmann D, Sperhake J-P, Lutgehetmann M, Steurer S, Edler C, Heinemann A, et al. Autopsy findings and venous thromboembolism in patients with COVID-19:a prospective cohort study. Ann Intern Med 2020;173(4):268-77.
Elsoukkary SS, Mostyka M, Dillard A, Berman DR, Ma LX, Chadburn A, et al. Autopsy findings in 32 patients with COVID-19: a single- institution experience. Pathobiology 2021;88(1):56-68.
Himwaze CM, Telendiy V, Maate F, Mupeta S, Chitalu C, Chanda D, et al. Post-mortem examination of hospital inpatient COVID-19 deaths in Lusaka, Zambia - a descriptive whole-body autopsy series. Int J Infect Dis 2021;108:363-9. doi: 10.1016/j.ijid.2021.06.013
Bradley BT, Maioli H, Johnston R, Chaudhry I, Fink SL, Xu H, et al. Histopathology and ultrastructural findings of fatal COVID-19 infections in Washington State: a case series. Lancet 2020;396(10247):320-32.
Falasca L, Nardacci R, Colombo D, Lalle E, Di Caro A, Nicastri E, et al. Postmortem findings in Italian patients with COVID-19: a descriptive full autopsy study of cases with and without comorbidities. J Infect Dis 2020;222(11):1807-15.
Edler C, Schroder AS, Aepfelbacher M, Fitzek A, Heinemann A, Heinrich F, et al. Dying with SARS-CoV-2 infection-an autopsy study of the first consecutive 80 cases in Hamburg, Germany. Int J Legal Med 2020;134(4):1275-84.
Carsana L, Sonzogni A, Nasr A, Rossi RS, Pellegrinelli A, Zerbi P, et al. Pulmonary post-mortem findings in a series of COVID-19 cases from northern Italy: a two-centre descriptive study. Lancet Infect Dis 2020;20(10):1135-40.
Rosen DG, Lopez AE, Anzalone ML, Wolf DA, Derrick SM, Florez LF, et al. Postmortem findings in eight cases of influenza A/H1N1. Mod Pathol 2010;23(11): 1449-57. doi: 10.1038/modpathol.2010.148
Nakajima N, Sato Y, Katano H, Hasegawa H, Kumasaka T, Hata S, et al. Histopathological and immunohistochemical findings of 20 autopsy cases with 2009 H1N1 virus infection. Mod Pathol 2012;25(1):1-13. doi:10.1038/modpathol.2011.125
Gao R, Pan M, Li X, Zou X, Zhao X, Li T, et al. Post-mortem findings in a patient with avian influenza A (H5N6) virus infection. Clin Microbiol Infect 2016;22(6):574.e1-574.e5745. doi: 10.1016/j.cmi.2016.03.017
Downloads
Published
Issue
Section
License
Copyright (c) 2022 Buddhachinaraj Medical Journal
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
