scholarly journals The Evolution of COVID-19: A Minimal Invasive Autopsy Cohort Studying in Depth the Different COVID- 19 Disease Stages

2021 ◽  
Author(s):  
Valentino D’Onofrio ◽  
Lotte Keulen ◽  
Annelore Vandendriessche ◽  
Jasperina Dubois ◽  
Reinoud Cartuyvels ◽  
...  
Keyword(s):  
Diffuse Alveolar Damage ◽  
Minimal Invasive ◽  
Disease Classification ◽  
Acute Disease ◽  
Histopathological Changes ◽  
Pathophysiological Mechanisms ◽  
Tailored Treatment ◽  
Moderate Disease ◽  
Disease Stages

Abstract Background The WHO defines different COVID-19 disease stages, where pathophysiological mechanisms differ. Clinical, radiological, histological, microbiological, and immunological characteristics of different COVID-19 disease stages were evaluated. Methods Forty-four PCR-confirmed COVID-19 patients were included in a prospective minimal invasive autopsy cohort. Patients were classified according to WHO disease classification in mild-moderate (n=4), severe-critical (n=32) and post-acute disease (n=8) and clinical, radiological, histological, microbiological, and immunological data were compared. Results Classified according to Thoracic Society of America, patients with mild-moderate disease had no typical COVID-19 images on CT-Thorax versus 71.9% with typical images in severe-critical disease and 87.5% typical images in post-acute disease (p<.001). Diffuse alveolar damage was absent in mild-moderate disease but present in 93.8% and 87.5% of patients with severe-critical and post-acute COVID-19, respectively (p=.002). Other organs with histopathological changes were liver and heart. Interferon-g levels were significantly higher in patients with severe-critical COVID-19. Overall, 72% of patients had positive anti-SARS CoV-2 IgM and 51% positive IgG. Conclusion Significant differences in pathological and immunological characteristics between patients with mild-moderate disease compared to patients with severe-critical disease were found, whereas differences between patients with severe-critical disease and post-acute disease were limited. This emphasizes the need for tailored treatment of COVID-19 patients.

scholarly journals Systematic Review of Microthrombi in COVID-19 Autopsies

2021 ◽  
pp. 1-8
Author(s):  
Rafael Parra-Medina ◽  
Sabrina Herrera ◽  
Jaime Mejia
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Pulmonary Embolism ◽  
Arterial Hypertension ◽  
Diabetes Mellitus Type 2 ◽  
Diffuse Alveolar Damage ◽  
Histopathological Analysis ◽  
Histopathological Changes ◽  
Age Range

<b><i>Background:</i></b> Histopathological analysis can provide additional clues in COVID-19 understanding. During the last year, autopsy reports have revealed that diffuse alveolar damage (DAD) is the most significant observed finding. The aim of this study is to review cases in the literature about COVID-19 autopsies that reported microthrombi in different organs. <b><i>Methods:</i></b> We performed a systematic literature review in PubMed, Virtual Health Library (VHL), and Google Scholar. <b><i>Results:</i></b> In total, 151 autopsies were included, and 91 cases presented microthrombi in the lung (73%), heart (11.2%), kidney (24%), and liver (16.3%). The age range was between 27 and 96 years. Males were 64.8%. The patients with microthrombi had more comorbidities such as arterial hypertension (62%), obesity or overweight (64%), diabetes mellitus type 2 (51%), and heart disease (53%). The most common histopathological changes found in patients with lung microthrombosis were DAD in exudative phase (78%), pulmonary embolism (59%), and lung infarct (81%). Presence of microthrombi was associated with arterial hypertension (<i>p</i> &#x3c; 0.0001) and DAD in exudative and proliferative phases (<i>p</i> = 0.02). <b><i>Discussion:</i></b> The analysis of these results shows that microthrombi in COVID-19 autopsies may be found in different organs and are more frequent in patients with comorbidities, pulmonary embolism, and lung infarct.

scholarly journals The pulmonary pathology of COVID-19

2021 ◽  
Vol 478 (1) ◽  
pp. 137-150
Author(s):  
Hans Bösmüller ◽  
Matthias Matter ◽  
Falko Fend ◽  
Alexandar Tzankov
Keyword(s):  
Viral Infections ◽  
Diffuse Alveolar Damage ◽  
High Viral Load ◽  
Lung Damage ◽  
Disease Stage ◽  
Lung Pathology ◽  
Open Questions ◽  
Cytokine Levels ◽  
Novel Coronavirus ◽  
Disease Stages

AbstractThe lung is the main affected organ in severe coronavirus disease 2019 (COVID-19) caused by the novel coronavirus SARS-CoV-2, and lung damage is the leading cause of death in the vast majority of patients. Mainly based on results obtained by autopsies, the seminal features of fatal COVID-19 have been described by many groups worldwide. Early changes encompass edema, epithelial damage, and capillaritis/endothelialitis, frequently combined with microthrombosis. Subsequently, patients with manifest respiratory insufficiency exhibit exudative diffuse alveolar damage (DAD) with hyaline membrane formation and pneumocyte type 2 hyperplasia, variably complicated by superinfection, which may progress to organizing/fibrotic stage DAD. These features, however, are not specific for COVID-19 and can be found in other disorders including viral infections. Clinically, the early disease stage of severe COVID-19 is characterized by high viral load, lymphopenia, massive secretion of pro-inflammatory cytokines and hypercoagulability, documented by elevated D-dimers and an increased frequency of thrombotic and thromboembolic events, whereas virus loads and cytokine levels tend to decrease in late disease stages, when tissue repair including angiogenesis prevails. The present review describes the spectrum of lung pathology based on the current literature and the authors’ personal experience derived from clinical autopsies, and tries to summarize our current understanding and open questions of the pathophysiology of severe pulmonary COVID-19.

Histopathological characteristics of multi-organ lesions in patients with COVID-19

2021 ◽  
Vol 22 (1) ◽  
pp. 53-60
Author(s):  
A. A. Odilov ◽  
◽  
N. S. Tsimbalist ◽  
A. V. Volkov ◽  
I. I. Babichenko ◽  
...  
Keyword(s):  
Distress Syndrome ◽  
Diffuse Alveolar Damage ◽  
Mortality Rates ◽  
Histopathological Changes ◽  
Lung Mass ◽  
Histological Changes ◽  
Foreign Countries ◽  
Direct Exposure ◽  
Pulmonary Parenchyma ◽  
Mass Increase

The main cause of death in COVID-19 patients is acute respiratory distress syndrome (ARDS) and multi-organ failure, which is often caused by extrapulmonary dissemination and the direct damaging effect of SARS-COV-2 on the vital organs tissues. However, the nature of histopathological changes in vital organs and their significance in the thanatogenesis of COVID-19 remain insufficiently studied. Purpose of the research. To study the nature of histopathological changes in organs in COVID-19 patients, and to conduct a comparative analysis of the data obtained with the results of foreign countries’ studies with high mortality rates. Materials and methods. A pathologic study of 179 deceased COVID-19 patients was conducted. The median age of patients was 71 years. In 83.8% (150/179) of cases, COVID-19 was the main disease, and in 16.2% (29/179) of cases, it was concomitant. Results and discussion. Histopathological changes in COVID-19 were multi-organ in nature, which caused ARDS in 91.62%, cardiovascular insufficiency in 27.4%, brain edema – in 20.1%, pulmonary edema – in 3.9%, and pulmonary embolism – in 3.9% of cases. The morphological signs of ARDS in COVID-19 were: lung mass increase in 78.2% of cases, foci of pulmonary parenchyma compaction – 74.8%, discoloration of lung tissue – 60.3%, signs of congestion – 58.1%, the histological basis of which was diffuse alveolar damage. Conclusion. Old age and concomitant chronic diseases of vital organs are the main risk factors for death in COVID-19. Histological changes in organs can be the result of both direct exposure to the virus and hypoxic, metabolic, and ischemic damage.

scholarly journals Fatal pulmonary fibrosis: a post-COVID-19 autopsy case

2020 ◽  
pp. jclinpath-2020-206879 ◽  
Author(s):  
Hanna Ferløv Schwensen ◽  
Line Kristine Borreschmidt ◽  
Merete Storgaard ◽  
Søren Redsted ◽  
Steffen Christensen ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Pulmonary Fibrosis ◽  
Microscopic Examination ◽  
Diffuse Alveolar Damage ◽  
Ct Scans ◽  
Autopsy Case ◽  
Histopathological Changes ◽  
History Of ◽  
Caucasian Female

There is growing evidence of histopathological changes in autopsied individuals infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); however, data on histopathological changes in autopsied patients with eradicated COVID-19 are limited. We performed an autopsy on a Caucasian female in her 80s, who died due to severe, bilateral pulmonary fibrosis after eliminated SARS-CoV-2 infection. In addition, CT scans from 2 months before infection and from 6 days prior to death were compared. Comparison of the CT scans showed bilateral development of widespread fibrosis in previously healthy lungs. Microscopic examination showed different areas with acute and organising diffuse alveolar damage and fibrosis with honeycomb-like remodelling and bronchial metaplasia. We here report a unique autopsy case with development of widespread pulmonary fibrosis in a woman in her 80s with previous COVID-19 and no history of pulmonary illnesses.

scholarly journals Case Report: Suspected COVID-19 death in the community - histological lung findings and the challenges faced by the pathologist

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 348
Author(s):  
Megan Jenkins ◽  
Oliver Johnson ◽  
Tim Helliwell ◽  
Christopher Paul Johnson
Keyword(s):  
Case Report ◽  
Diffuse Alveolar Damage ◽  
Post Mortem ◽  
Pathological Findings ◽  
Histopathological Changes ◽  
Short History ◽  
Global Pandemic ◽  
Lung Histology ◽  
Growing Body ◽  
History Of

Coronavirus disease 2019 (COVID‐ 19) has now been declared a global pandemic. The literature on the histopathological changes associated with COVID-19 infection is currently limited. Early data consistently describe diffuse alveolar damage on lung histology from patients with COVID-19 pneumonia. We present the case of a 65-year-old female who died whilst self-isolating in the community following a short history of symptoms consistent with COVID-19. An invasive autopsy and subsequent lung histology demonstrated diffuse alveolar damage, in keeping with the previously reported cases of COVID-19 pneumonia. We hope to contribute to the growing body of literature available on the pathological findings in such cases. The challenges of ascertaining post mortem virological confirmation of infection are discussed.

Fine structure of early degenerating myofibers in the tibialis anterior of young ‘MDX’ mouse

1988 ◽  
Vol 46 ◽  
pp. 322-323
Author(s):  
H.D. Geissinger ◽  
C.K. McDonald-Taylor
Keyword(s):  
Fine Structure ◽  
Muscle Regeneration ◽  
Tibialis Anterior ◽  
Genetic Defect ◽  
Mdx Mouse ◽  
Mdx Mice ◽  
Histopathological Changes ◽  
Electron Microscopic ◽  
Dystrophic Mouse ◽  
Preliminary Study

A new strain of mice, which had arisen by mutation from a dystrophic mouse colony was designated ‘mdx’, because the genetic defect, which manifests itself in brief periods of muscle destruction followed by episodes of muscle regeneration appears to be X-linked. Further studies of histopathological changes in muscle from ‘mdx’ mice at the light microscopic or electron microscopic levels have been published, but only one preliminary study has been on the tibialis anterior (TA) of ‘mdx’ mice less than four weeks old. Lesions in the ‘mdx’ mice vary between different muscles, and centronucleation of fibers in all muscles studied so far appears to be especially prominent in older mice. Lesions in young ‘mdx’ mice have not been studied extensively, and the results appear to be at variance with one another. The degenerative and regenerative aspects of the lesions in the TA of 23 to 26-day-old ‘mdx’ mice appear to vary quantitatively.

The Fine Structure of Irradiated Mouse Heart

1976 ◽  
Vol 34 ◽  
pp. 184-185
Author(s):  
Vivian V. Yang ◽  
S. Phyllis Stearner
Keyword(s):  
Microscopic Level ◽  
Ultrastructural Changes ◽  
Mouse Heart ◽  
Blood Vessel Wall ◽  
Histopathological Changes ◽  
Light Microscopic Level ◽  
Γ Rays ◽  
Fission Neutrons ◽  
Total Body

The heart is generally considered a radioresistant organ, and has received relatively little study after total-body irradiation with doses below the acutely lethal range. Some late damage in the irradiated heart has been described at the light microscopic level. However, since the dimensions of many important structures of the blood vessel wall are submicroscopic, investigators have turned to the electron microscope for adequate visualization of histopathological changes. Our studies are designed to evaluate ultrastructural changes in the mouse heart, particularly in the capillaries and muscle fibers, for 18 months after total-body exposure, and to compare the effects of 240 rad fission neutrons and 788 rad 60Co γ-rays.Three animals from each irradiated group and three control mice were sacrificed by ether inhalation at 4 days, and at 1, 3, 6, 12, and 18 months after irradiation. The thorax was opened and the heart was fixed briefly in situwith Karnofsky's fixative.

103: Minimal Invasive Treatment of Men with Cathegory IIIB (CPPS) Prostatitis. A Prospective Multicenter Trial: Results of the MICP Study

2007 ◽  
Vol 177 (4S) ◽  
pp. 36-36
Author(s):  
Bob Djavan ◽  
Christian Seitz ◽  
Martina Nowak ◽  
Michael Dobrovits ◽  
Mike Harik ◽  
...  
Keyword(s):  
Multicenter Trial ◽  
Minimal Invasive ◽  
Invasive Treatment ◽  
Minimal Invasive Treatment ◽  
Prospective Multicenter Trial

60: Minimal Invasive Treatment of Ureteropelvic Junction Obstruction in Low Volume Pelvis: A Comparison of Endopyelotomy and Laparoscopic Nondismembered Pyeloplasty

2005 ◽  
Vol 173 (4S) ◽  
pp. 17-17
Author(s):  
Anant Kumar ◽  
Devendra Kumar ◽  
Aneesh Srivastava ◽  
Anil Mandhani ◽  
Rakesh Kapoor ◽  
...  
Keyword(s):  
Ureteropelvic Junction Obstruction ◽  
Minimal Invasive ◽  
Ureteropelvic Junction ◽  
Invasive Treatment ◽  
Minimal Invasive Treatment ◽  
Low Volume

Tailored treatment investigations using predictive factors

2002 ◽  
Vol 38 (11) ◽  
pp. S125
Author(s):  
R Gelber
Keyword(s):  
Predictive Factors ◽  
Tailored Treatment
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