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The management of the activity of the pathology and anatomical service (PAS) of the Moscow Healthcare Department (DZM) in the context of the COVID-19 pandemic and the provision of timely and accurate pathological diagnostics, as well as the receipt of reliable statistics on mortality rate, made it possible to provide timely management decisions to combat the pandemic. Purpose. To present the successful experience of managing the activities of the Moscow Pathoanatomic Service of DZM in the conditions of a pandemic of a new coronavirus infection. Methods. The paper analyzes and summarizes the features of the activity of PAS of DZM in the conditions of the COVID-19 pandemic, presents the main activities carried out to ensure timely and accurate diagnostics in anatomical pathology, and obtaining reliable statistical data on mortality, demonstrates the most important management decisions for organizing work aimed at combating the pandemic. Analytical, organizational, and statistical research methods are used in the work. Results. In order to improve the organization of the work of PAS of DZM in the context of the COVID-19 pandemic and ensure timely and accurate pathological diagnostics, and obtaining reliable statistics on mortality from it, a number of important activities were carried out including reprofilation of the PAS and reorganization of the work of PAS of DZM, reorganization and optimization of the work of the organizational and methodological department for pathological anatomy (OMO PA) of the Research Institute for Healthcare Organization and Medical Management of Moscow Healthcare Department, carrying out activities to establish interaction between the chief specialist in pathological anatomy and OMO PA with the DZM, the Rosstat and the egistry Office in Multiple functional Centres, connection of all Departments of Pathology by the new laboratory information system «LABFORS», development of continuing medical education. Limitations. Limited time period for description; there is no comparison with other subjects; conditions of the COVID-19 epidemic. Conclusions. Thus, the PAS of DZM, under the guidance of the chief specialist in pathological anatomy of DZM and OMO PA, showed its efficiency and effectiveness in the context of a pandemic of a new coronavirus infection, successfully implemented new technologies and organizational principles, improved the organization of its work, developed both post-mortem and intravital diagnostics of diseases in anatomical pathology.

Introduction. When compiling the final clinical, pathoanatomical and forensic diagnoses, as well as choosing and coding ac-cording to ICD-10 the initial cause of death in patients after organ transplantation, difficulties often arise due to the lack of unified recommendations.Materials and methods. We analyzed 60 protocols of post-mortem autopsies of lethal outcomes in patients after organ transplantation at the Sklifosovsky Research Institute of Emergency Medicine, Moscow for 7 years (from 2016 to 2022).Results. Based on the results of the analysis, taking into account the literature data, recommendations were formulated on the formulation of the final clinical, pathoanatomical and forensic diagnoses, selection and coding according to ICD-10 of the initial cause of death in patients after solid organ transplantation.Findings. The developed recommendations on the formulation of the final clinical, pathoanatomical and forensic diagnoses in cases of death of patients after solid organ transplantation can be used in the daily practice of clinical doctors, pathologists and forensic experts.

This article represents the discussion of a clinical case of superior sagittal sinus thrombosis as a focal point of fatal pulmonary embolism. Pulmonary embolism is a life-threatening condition, with a mortality rate of up to 40%. The direct source of pulmonary embolism is deep vein thrombosis of the lower extremities and pelvis in 80–90% of all cases. The veins of the upper extremities and venous heart cause it less often. Pulmonary embolism in patients with cerebral venous thrombosis is observed in 1.4% of patients.Cerebral venous thrombosis is a cerebrovascular disease manifested by venous outflow disorders due to acute occlusion of the sinuses and veins of the brain. It requires immediate treatment in order to prevent the development of intracranial hemorrhage, venous infarction, disability and death. Cerebral venous thrombosis accounts for approximately 0.5% of all cases of cerebrovascular disease worldwide. In contrast to ischemic stroke, cerebral venous thrombosis is more common in younger patients. Currently, the diagnosis of cerebral venous thrombosis is based on neuroimaging data, and timely treatment leads to a decrease in disability and mortality.

Background: The damage to the nervous system in COVID-19 reflects the systemic nature of the infection. The question of the neuroinvasive potential of SARS-CoV-2 remains open, the role of "pseudovirions" in the development of the endothelial dysfunction, as well as of the S1 subunit in the TLR activation, and the importance of the blood-brain barrier are discussed. The immunological, non-immunological, and cytopathic mechanisms of the virus's action are described; there is no clear understanding of the genesis of neuropathological changes caused by SARS-CoV-2. In this tragic pandemic, the lessons of the dead should help save lives and health. Aim: to study and explain the features of brain damage in COVID-19. Methods: Brain fragments from 20 patients who died due to severe COVID-19 were studied, the sections were stained with hematoxylin and eosin, according to van Gieson and Nissl, IHC reactions were performed with antibodies to the S-protein, CD68 and CD8, the changes were compared with those related to the lethal outcomes of pancreatic necrosis and ruptured aortic aneurysm. Results: The following changes in the olfactory analyzer were revealed: sharp edema, dystrophic changes in neurons, gliosis, accumulations of starchy bodies, which explains the neuronal pathway of SARS-CoV-2 invasion; vascular plethora, erythrostasis and thrombosis, perivenular hemorrhages, diffuse edema, macroglia proliferation, perivascular astrocytosis and satellite. A positive reaction with the antibodies to the S1 and S2 subunits of the spike protein was detected, while the result of the reaction with antibodies to the N-protein of the virus, confirming the active replication of the virus, was doubtful. The S-protein expression in individual endotheliocytes makes the transendothelial route of the virus entry unlikely, in contrast to the hematogenous and neuronal pathways. The viral DNA was not detected by PCR. A weak inflammatory reaction was revealed in the form of perivascular accumulations of lymphocytes, scattered T-lymphocytes. Conclusions: 2 groups of changes were identified, the first group included circulatory disorders with a tendency to thrombosis, edema, dystrophic-necrotic changes in neurons, glial proliferation, the second group included inflammatory-degenerative changes, a weak inflammatory reaction and amyloid-like bodies. Further morphometric and statistical studies are needed to obtain the reliable conclusions.