Postmortem Cardiopulmonary Pathology in Patients with COVID-19 Infection: Single-Center Report of 12 Autopsies from Lausanne, Switzerland.

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State: Public
Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_00E678B7BCC1
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Postmortem Cardiopulmonary Pathology in Patients with COVID-19 Infection: Single-Center Report of 12 Autopsies from Lausanne, Switzerland.
Journal
Diagnostics
Author(s)
Berezowska S., Lefort K., Ioannidou K., Ndiaye D.R., Maison D., Petrovas C., Rotman S., Piazzon N., Milowich D., Sala N., Tsai C.Y., Multone E., Bochud P.Y., Oddo M., Bisig B., de Leval L.
ISSN
2075-4418 (Print)
ISSN-L
2075-4418
Publication state
Published
Issued date
28/07/2021
Peer-reviewed
Oui
Volume
11
Number
8
Pages
1357
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
We report postmortem cardio-pulmonary findings including detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in formalin-fixed paraffin embedded tissue in 12 patients with COVID-19. The 5 women and 7 men (median age: 73 years; range 35-96) died 6-38 days after onset of symptoms (median: 14.5 days). Eight patients received mechanical ventilation. Ten patients showed diffuse alveolar damage (DAD), 7 as exudative and 3 as proliferative/organizing DAD. One case presented as acute fibrinous and organizing pneumonia. Seven patients (58%) had acute bronchopneumonia, 1/7 without associated DAD and 1/7 with aspergillosis and necrotic bronchitis. Microthrombi were present in 5 patients, only in exudative DAD. Reverse transcriptase quantitative PCR detected high virus amounts in 6 patients (50%) with exudative DAD and symptom-duration ≤14 days, supported by immunohistochemistry and in-situ RNA hybridization (RNAscope). The 6 patients with low viral copy levels were symptomatic for ≥15 days, comprising all cases with organizing DAD, the patient without DAD and one exudative DAD. We show the high prevalence of DAD as a reaction pattern in COVID-19, the high number of overlying acute bronchopneumonia, and high-level pulmonary virus detection limited to patients who died ≤2 weeks after onset of symptoms, correlating with exudative phase of DAD.
Keywords
COVID-19, RNAscope, SARS-CoV-2, autopsy, diffuse alveolar damage, immunohistochemistry, post-mortem diagnostics, reverse transcriptase quantitative PCR
Pubmed
Web of science
Open Access
Yes
Funding(s)
Swiss National Science Foundation / 310030_172954
Swiss National Science Foundation / 31CA30_196852
Create date
30/07/2021 7:41
Last modification date
04/09/2021 6:34
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