Histopathological findings in the advanced natural evolution of the SARS-CoV-2 infection

Cîrstea, Andreea-Elena; Buzulică, R; Pirici, Daniel; Ceauşu, M; Iman, Radu Vasile; Gheorghe, Ovidiu-Mircea; Neamţu, Simona Daniela; Stanca, Liliana; Ene, Răzvan; Kumar‐Singh, Samir; Mogoantă, Laurențiu

doi:10.47162/rjme.61.1.23

Cited by 19 publications

(37 citation statements)

References 42 publications

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“…Acute myocardial ischemia was evident in 25 cases either in the form of acute myocardial infarction (MI) ( n = 11) or microscopic evidence of acute or early ischemia ( n = 14). Moreover, fibrin microvascular thrombi were identifiable in 27 cases ( 6 , 8 , 35 , 36 , 42 , 47 , 48 ). Thrombi in cardiac veins were described in three cases ( 8 , 10 ).…”

Section: Resultsmentioning

confidence: 99%

“…Thrombi in cardiac veins were described in three cases ( 8 , 10 ). Lastly, there was eight cases with mural thrombi including the heart valves ( n = 3) and the right atrium (RA) ( n = 1) ( 10 , 35 , 47 , 48 ).…”

Section: Resultsmentioning

confidence: 99%

“…Myocardial ischemia, thrombosis, and cardiac dilatation were the most dominant acute findings ( Figure 2 ). Prevalence of the non-specific myocardial edema (ME) was 100% in the six studies reporting it ( 6 , 15 , 19 , 35 , 44 , 45 ). The highly prevalent chronic cardiac pathologies not only reflect the impact of cardiac comorbidities but also complicated the histopathological interpretation.…”

Section: Discussionmentioning

confidence: 99%

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COVID-19 and the Heart: A Systematic Review of Cardiac Autopsies

Roshdy

Zaher

Fayed

et al. 2021

Front. Cardiovasc. Med.

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Importance: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-associated cardiac injury has been postulated secondary to several mechanisms. While tissue diagnosis is limited during the acute illness, postmortem studies can help boost our understanding and guide management.Objective: To report the cardiac tissue autopsy findings in coronavirus disease 2019 (COVID-19) decedents.Evidence Review: Articles published in PubMed and Embase reporting postmortem cardiac pathology of COVID-19 decedents till September 2020. We included adult studies excluding preprints. The Joanna Briggs Institute Critical Appraisal Checklist for Case Reports was used to assess quality. We extracted gross and histology data as well as the incidence of myocarditis, cardiac ischemia, thrombosis, and dilatation. We also looked at the reported cause of death (PROSPERO registration CRD42020190898).Findings: Forty-one relevant studies identified including 316 cases. The deceased were mostly male (62%) and elderly (median age, 75; range, 22–97 years). The most common comorbidities were hypertension (48%) and coronary artery disease (33%). Cardiac pathologies contributed to the death of 15 cases. Besides chronic cardiac pathologies, postmortem examination demonstrated cardiac dilatation (20%), acute ischemia (8%), intracardiac thrombi (2.5%), pericardial effusion (2.5%), and myocarditis (1.5%). SARS-CoV-2 was detected within the myocardium of 47% of studied hearts.Conclusions and Relevance: SARS-CoV-2 can invade the heart, but a minority of cases were found to have myocarditis. Cardiac dilatation, ischemia, mural, and microthrombi were the most frequent findings. The systematic review was limited by the small number of cases and the quality of the studies, and there is a need to standardize the cardiac postmortem protocols.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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COVID-19 and the Heart: A Systematic Review of Cardiac Autopsies

Roshdy

Zaher

Fayed

et al. 2021

Front. Cardiovasc. Med.

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“…Although after the MERS eradication, coronaviruses scenario was forgotten, but the emergence of SARS-CoV-2 has sounded the alarms for human health. The origin of SARS-CoV-2 like MERS and SARS-CoV is bats and the first time was observed in Wuhan (December 2019), China (Cîrstea et al, 2020 ). Since the outbreak, millions of infections and deaths have been due to SARS-CoV-2.…”

Section: Introductionmentioning

confidence: 99%

“…Coronavirus could affect various vital organs of human especially who has suffered from underling diseases; however, the many pathophysiological pathways of it remain unclear. In addition, mutation and changes in the structure of coronavirus could also consider as other obstacles to finding proper treatment against it (Cao et al, 2020 ; Chen, 2020 ; Cîrstea et al, 2020 ; Vinayagam & Sattu, 2020 ; Walls et al, 2020 ). Among the proposed molecular targets, 3CLpro (Main protease), PLpro (Papin-like protease), RdRp (RNA-dependent RNA polymerase) are main candidates for SARS-CoV-2 inhibition (Morse et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Insight into molecular characteristics of SARS-CoV-2 spike protein following D614G point mutation, a molecular dynamics study

Gomari

Rostami

Omidi-Ardali

et al. 2021

Journal of Biomolecular Structure and Dynamics

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Undoubtedly, the SARS-CoV-2 has become a major concern for all societies due to its catastrophic effects on public health. In addition, mutations and changes in the structure of the virus make it difficult to design effective treatment. Moreover, the amino acid sequence of a protein is a major factor in the formation of the second and tertiary structure in a protein. Amino acid replacement can have noticeable effects on the folding of a protein, especially if an asymmetric change (substitution of polar residue with non-polar, charged with an uncharged, positive charge with a negative charge, or large residue with small residue) occurs. D614G as a spike mutant of SARS-CoV-2 previously identified as an associated risk factor with a high mortality rate of this virus. Using structural bioinformatics, our group determined that D614G mutation could cause extensive changes in SARS-CoV-2 behavior including the secondary structure, receptor binding pattern, 3D conformation, and stability of it.

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Implications of microscale lung damage for COVID-19 pulmonary ventilation dynamics: A narrative review

et al. 2021

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The COVID-19 pandemic surges on as vast research is produced to study the novel SARS-CoV-2 virus and the disease state it induces. Still, little is known about the impact of COVID-19-induced microscale damage in the lung on global lung dynamics. This review summarizes the key histological features of SARS-CoV-2 infected alveoli and links the findings to structural tissue changes and surfactant dysfunction affecting tissue mechanical behavior similar to changes seen in other lung injury. Along with typical findings of diffuse alveolar damage affecting the interstitium of the alveolar walls and blood-gas barrier in the alveolar airspace, COVID-19 can cause extensive microangiopathy in alveolar capillaries that further contribute to mechanical changes in the tissues and may differentiate it from previously studied infectious lung injury. Understanding microlevel damage impact on tissue mechanics allows for better understanding of macroscale respiratory dynamics. Knowledge gained from studies into the relationship between microscale and macroscale lung mechanics can allow for optimized treatments to improve patient outcomes in case of COVID-19 and future respiratory-spread pandemics.

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Histopathological findings in the advanced natural evolution of the SARS-CoV-2 infection

Abstract: We are reporting a case of natural evolution and pathological data from a young person that was diagnosed with coronavirus disease 2019 . All data has been collected from the autopsy of a 30-year-old female, which was performed by the

Cited by 19 publications

References 42 publications

COVID-19 and the Heart: A Systematic Review of Cardiac Autopsies

COVID-19 and the Heart: A Systematic Review of Cardiac Autopsies

Insight into molecular characteristics of SARS-CoV-2 spike protein following D614G point mutation, a molecular dynamics study

Implications of microscale lung damage for COVID-19 pulmonary ventilation dynamics: A narrative review

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