Clinicopathologic and Immunohistochemical Findings from Autopsy of Patient with COVID-19, Japan

Adachi, Takuya; Chong, Ja Mun; Nakajima, N.; Sano, Masahiro; Yamazaki, Jun; Miyamoto, Ippei; Nishioka, Haruka; Akita, Hidetaka; Sato, Yuko; Kataoka, Michiyo; Katano, Harutaka; Tobiume, Minoru; Sekizuka, Tsuyoshi; Itokawa, Kentaro; Kuroda, Makoto; Suzuki, Tadaki

doi:10.3201/eid2609.201353

Cited by 134 publications

(163 citation statements)

References 11 publications

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“…It is noteworthy that this latter IHC was negative in different post-mortem tissues including the heart, intestine, skin, liver, and bone marrow [31]. The same antibody was used in other studies [43] as well as for immunofluorescent microscopic visualization of infected cells in bronchoalveolar lavage specimens [3].…”

Section: Other Tissue Techniquesmentioning

confidence: 99%

“…Adachi et al reported the autopsy of an 84-year-old cruise ship passenger who died from COVID-19 and lung pathology showed exudative and organizing phases of DAD, similar to that observed in the cases of severe acute respiratory syndrome. By evaluating copy numbers of SARS-CoV-2 by real-time PCR in different specimens, the authors found that the virus principally attacked the respiratory tract and was significantly less present in other organs (brain, heart, testicles, and kidney) and in specimens such as blood, urine, feces, and rectal swab [43]. Yan et al described an obese female patient of 44 years, showing for the first time an extensive and widespread perivascular lymphocytic cuffing with few foci of infiltration within vessel walls but without fibrinoid necrosis, consistent with non-necrotizing lymphocytic vasculitis.…”

Section: Pathology Of Lung Lesions In Covid Deceased Patientsmentioning

confidence: 99%

“…Moreover, a forensic case of a sudden unexpected death was related to COVID-19 after analyzing dacron-tipped swabs of the right and left main bronchi [38]. More recently, also other cases have been investigated in post-mortem cytological samples, not only in swabs [43,45,47,49] but also in pleural effusions [47].…”

Section: Ancillary Tools: Cytologymentioning

confidence: 99%

“…Pleural effusions were radiologically and/or grossly mentioned in different studies on autoptic cases [42,43,45,47,50]. In particular, when case series were reported, the prevalence of pleural effusions was either relatively small (9% and 33%) [42,45] or was not specified [47,50].…”

Section: Ancillary Tools: Cytologymentioning

confidence: 99%

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Pulmonary pathology and COVID-19: lessons from autopsy. The experience of European Pulmonary Pathologists

et al. 2020

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Since its initial recognition in December 2019, Coronavirus disease 19 (COVID-19) has quickly spread to a pandemic infectious disease. The causative agent has been recognized as a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), primarily affecting the respiratory tract. To date, no vaccines are available nor any specific treatment. To limit the number of infections, strict directives have been issued by governments that have been translated into equally rigorous guidelines notably for post-mortem examinations by international and national scientific societies. The recommendations for biosafety control required during specimen collection and handling have strongly limited the practice of autopsies of the COVID-19 patients to a few adequate laboratories. A full pathological examination has always been considered an important tool to better understand the pathophysiology of diseases, especially when the knowledge of an emerging disorder is limited and the impact on the healthcare system is significant. The first evidence of diffuse alveolar damage in the context of an acute respiratory distress syndrome has now been joined by the latest findings that report a more complex scenario in COVID-19, including a vascular involvement and a wide spectrum of associated pathologies. Ancillary tools such as electron microscopy and molecular biology used on autoptic tissue samples from autopsy are also significantly contributing to confirm and/or identify new aspects useful for a deeper knowledge of the pathogenetic mechanisms. This article will review and summarize the pathological findings described in COVID-19 until now, chiefly focusing on the respiratory tract, highlighting the importance of autopsy towards a better knowledge of this disease.

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Section: Other Tissue Techniquesmentioning

confidence: 99%

Section: Pathology Of Lung Lesions In Covid Deceased Patientsmentioning

confidence: 99%

Section: Ancillary Tools: Cytologymentioning

confidence: 99%

Section: Ancillary Tools: Cytologymentioning

confidence: 99%

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Pulmonary pathology and COVID-19: lessons from autopsy. The experience of European Pulmonary Pathologists

et al. 2020

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“…Similarly, these reports describe general ndings and the presence of MKs is not further commented. In the remaining autopsy studies, including a review article there are no references to MKs [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28]41]. Various reasons could explain this absence.…”

Section: Discussionmentioning

confidence: 99%

Increased number of pulmonary megakaryocytes in COVID-19 patients with diffuse alveolar damage. An autopsy study with clinical correlation and review of the literature.

Valdivia-Mazeyra

Salas

Nieves-Alonso

et al. 2020

Preprint

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Megakaryocytes are normally present in the lung where they play a role in platelet homeostasis. The latter are well known to participate in the pathogenesis of lung damage, particularly in acute lung injury. Although megakaryocytes are usually not mentioned as a characteristic histopathologic finding associated to acute pulmonary injury, a few studies point out that their number is increased in the lungs of patients with diffuse alveolar damage. In this autopsy study we have observed a relevant number of pulmonary megakaryocytes in COVID-19 patients dying with acute respiratory distress syndrome. We have studied pulmonary tissue samples of 18 patients most of which died after prolonged disease and use of mechanical ventilation. Most samples showed fibroproliferative or fibrotic diffuse alveolar damage and an increased number of megakaryocytes. In six, thrombi of the pulmonary microcirculation were seen. We compare our findings with previous published autopsy reports, mainly focusing on the description of megakaryocytes. Our patients showed abnormal coagulation parameters with high levels of fibrinogen, D-dimers and variable thrombocytopenia. Since the lung is considered an active site of megakariopoiesis, a prothrombotic status leading to platelet activation, aggregation and consumption may trigger a compensatory pulmonary response. An increased number of pulmonary megakaryocytes suggests and supports a relation with the thrombotic events so often seen in COVID-19. Regardless of its etiology, future studies of patients dying with acute pulmonary injury should include pulmonary megakaryocytes as a histologic variable of interest.

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An autopsy case of COVID‐19 with a sudden death: Clinico‐pathological comparison

Shishido‐Hara

Furukawa²,

Nishio³

et al. 2022

Clinical Case Reports

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Clinicopathologic and Immunohistochemical Findings from Autopsy of Patient with COVID-19, Japan

Cited by 134 publications

References 11 publications

Pulmonary pathology and COVID-19: lessons from autopsy. The experience of European Pulmonary Pathologists

Pulmonary pathology and COVID-19: lessons from autopsy. The experience of European Pulmonary Pathologists

Increased number of pulmonary megakaryocytes in COVID-19 patients with diffuse alveolar damage. An autopsy study with clinical correlation and review of the literature.

An autopsy case of COVID‐19 with a sudden death: Clinico‐pathological comparison

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